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Monday, September 26, 2016: 2:00 PM
Purpose: Breast implant rupture is an important complication increasing as time goes by. Ruptures usually start at shell rupture and gradually proceed to intracapsular rupture, and finally growth to extracapsular rupture or silicone granuloma. Ruptured implants are recommended to be exchanged before causing silicone granuloma. But smaller number of lifetime reoperations is desirable on the other hand, so it is important to ascertain the appropriate timing to undergo the operation. Although magnetic resonance imaging is the gold standard, ultrasonography is recently recognized as a fast and convenient method to detect rupture. The aim of this study is to reveal rupture rate and to define typical signs for shell rupture and intracapsular rupture.
Methods: This study included 345 women with 460 implants (379 breast reconstruction and 81 contralateral breast augmentation, all of them were Natrelle 410 breast implant) who were undergone breast reconstruction surgery after mastectomy in 2005-2010 in our institute. From 2014, the authors started ultrasonography on annual visiting. Plastic surgeons or ultrasound technicians evaluated implants with high frequancy linear probe(12MHz) and classify them into 5 signs (normal, minor shell split, isolated liquid sign, hyperechoic gel between capsule and shell, and hyperechoic inner silicone gel). Magnetic resonance imaging and implant exchange was performed on possibly ruptured implants.
Results: Follow-up rate was 86%. Overall rupture rate at over 5 years was 3.3%(15 of 460 implants). Of those, 9 implants had been intracapsular ruptured (all of them were exchanged) and 6 implants had been shell ruptured (2 were exchanged and 4 were followed continuously). Two explanted implants which had shell rupture showed the ultrasonographic signs of minor shell split or isolated liquid sign. There were very small hole of the shell, but shell ruptured implants kept their form and cohesiveness. Nine implants which had intracapsular rupture had no longer their original form and lost their cohesiveness so it was difficult to remove leaked gel completely. Inracapsular ruptured implants showed both signs of hyperechoic gel between capsule and shell, and hyperechoic area in silicone gel.
Conclusions: Overall rupture rate was similar to Natrelle 410 Core Study. In this study, we could distinguish shell rupture from intracapsular rupture using ultrasound. And if the implant have been shell ruptured, we may wait and see carefully until it proceeds to intracapsular rupture.
Methods: This study included 345 women with 460 implants (379 breast reconstruction and 81 contralateral breast augmentation, all of them were Natrelle 410 breast implant) who were undergone breast reconstruction surgery after mastectomy in 2005-2010 in our institute. From 2014, the authors started ultrasonography on annual visiting. Plastic surgeons or ultrasound technicians evaluated implants with high frequancy linear probe(12MHz) and classify them into 5 signs (normal, minor shell split, isolated liquid sign, hyperechoic gel between capsule and shell, and hyperechoic inner silicone gel). Magnetic resonance imaging and implant exchange was performed on possibly ruptured implants.
Results: Follow-up rate was 86%. Overall rupture rate at over 5 years was 3.3%(15 of 460 implants). Of those, 9 implants had been intracapsular ruptured (all of them were exchanged) and 6 implants had been shell ruptured (2 were exchanged and 4 were followed continuously). Two explanted implants which had shell rupture showed the ultrasonographic signs of minor shell split or isolated liquid sign. There were very small hole of the shell, but shell ruptured implants kept their form and cohesiveness. Nine implants which had intracapsular rupture had no longer their original form and lost their cohesiveness so it was difficult to remove leaked gel completely. Inracapsular ruptured implants showed both signs of hyperechoic gel between capsule and shell, and hyperechoic area in silicone gel.
Conclusions: Overall rupture rate was similar to Natrelle 410 Core Study. In this study, we could distinguish shell rupture from intracapsular rupture using ultrasound. And if the implant have been shell ruptured, we may wait and see carefully until it proceeds to intracapsular rupture.