by Van Slyke,
Aaron C.; Carr, Michael; Carr, Nicholas J.
Background:
Augmentation mammaplasty is the most common aesthetic procedure. Textured
implants control implant position and have improved capsular contracture rates;
however, the impact of texturing on longevity and clinical findings at
explantation is unclear.
Methods: All
cases of explantation between January of 2005 and April of 2017 from an
aesthetic practice were reviewed retrospectively. Patient demographics, implant
characteristics, time to explantation, and clinical presentation and
intraoperative findings at explantation were analyzed. Results: Five hundred thirty-nine breast implants were explanted
during the study period: 249 saline, 147 smooth gel, 123 Biocell, and 20 other
nonaggressively textured breast implants. Average time from placement to
explantation was 7.5, 5.6, 4.9, and 4.0 years for saline, other textured,
smooth gel, and Biocell implants, respectively (p = 3.25e-08). The percentage
of implants removed associated with implant performance failure was 50.3, 57.4,
75.0, and 85.4 percent for smooth gel, saline, other textured, and Biocell
implants, respectively (p = 7.25e-09). In addition, 21.1 percent of Biocell
implants versus 1.4 percent of all other implants presented with pain (p =
2.71e-15). Forty-five Biocell implants had double capsules; this phenomenon was
not observed with any other implant type (p = 5.85e-37). Seven Biocell implants
had late seromas, compared to three late seromas with any other implant type (p
= 0.0013).
Conclusions:
Here, the authors provide evidence that Biocell implants have the shortest time
to explantation and the highest proportion of implants associated with implant performance
failure. This information should complement the informed consent process when
selecting an appropriate implant.
