A Ten-Year Experience Using The 410 Biodimensional System In Breast Augmentations

Introduction: With the recent FDA approval of silicone implants for augmentation mammoplasty, plastic surgeons and patients have a wider variety of implants to choose from. Although the newest generation of textured, anatomic, cohesive gel implants were introduced in 1993, they are not yet approved for use in the United States. These implants have been widely used in Brazil since 1996.

Purpose: The aim of this retrospective study was to evaluate the clinical results after using the McGhan Style 410, anatomic, cohesive gel implants for breast augmentation.

Patients and Methods: Five hundred and twenty-eight breast augmentations were performed on 266 patients by a single surgeon in Brazil from January 1997 to November 2006. These included 260 bilateral breast augmentations, and 6 unilateral augmentation procedures to treat breast asymmetry. Primary augmentation was performed in 243 patients, and implants were exchanged in 23 patients. The primary indications were post partum breast involution and/or micromastia. Patient ages ranged from 16 to 61 years (median 29 years). Follow-up ranged up to 5 years.

Operations for 241 patients (90.6%) were performed under local anesthesia with sedation, while 25 patients (9.4%) had their procedures performed under general anesthesia. The implant sizes ranged from 150cc to 375cc (median 300cc, mean 310 cc).

All patients were evaluated preoperatively with the Tebbetts "patient evaluation and operative planning sheet". Implant size was determined by the surgeon and patient, paying attention to her wishes and expectations, while considering her body dimensions and breast skin laxity. Placement of implants was subglandular in 85% of cases. Submuscular placement was chosen when the thickness of the pinched skin and subcutaneous tissue of the upper pole was less than 2cm. The incision was submammary in 98% of the patients.

Results: The postoperative course was uneventful in 97% of the patients. Eight patients had post operative complications. These included patients with implant rotation (2), seroma (1), hematoma (2), and visible rippling (3). All complications were managed successfully, without implant loss. In these patients, good final results were obtained. Capsular contracture (Baker I and II) was found in 1.5% of the operated breasts.

Conclusions: The McGhan Style 410 anatomical, cohesive, silicone gel implant for breast augmentation is an implant that looks and feels like a breast. Its dimensional shape produces a more natural and refined result, without the unnatural upper pole bulging commonly seen in round implants. Base width, height, and projection are variable, facilitating an aesthetic improvement in a wider range of breast types.