Soubirac L, Jougla E, Hezard L, Grolleau J L, Chavoin J P
Service de chirurgie plastique, reconstructrice et esthétique, service des grands brûlés, CHU de Toulouse Rangueil, 1, avenue Jean-Poulhès, 31403 Toulouse, France.
Ann Chir Plast Esthet. 2002 Aug;47(4):273-9. doi: 10.1016/s0294-1260(02)00119-x.
The main mechanical side effect of saline or hydrogel filled implants is deflation. The aim of this study was to analyse the prosthetic deflation rate in the last 7 years in the plastic surgery unit of Toulouse.
We tracked 650 patients operated on between july 1993 and july 2000 (representing 1117 primary implants) which we separated in two groups: the first group contained patients in need of breast reconstruction; the second group contained all the patients with implants placed for aesthetic or breast asymMetry reasons. For each of the two groups we determined the number and the type of implants, as well as the rate and the mean delay after which deflation occurred.
During this period, we've determined that: rate of deflation of group 1 (reconstruction) is highest than group 2 (aesthetic), despite sort of implant; rates of deflation of pre-filled hydrogel implants are highest than rates of deflation of pre-filled saline implants.
Only a few series concerning implants deflation have been described in the literature. We can find a large difference in results which vary from 2 to 76%. We were surprised by the result of our series with a rate of deflation up to 15% with a medium follow-up 5 years in both groups and a mean delay before the fourth year. Deflation's factors are numerous: type of sterilisation, rippling, texture, valve's incompetence, prosthetic patch, guarantee control and iatrogenic causes. Because the silicone gel implants (the one uncomplicated by deflation) were taken off the french market, the saline implants tried to supplant them but without satisfactory results.
With the unacceptable rate deflation of implants in our study, the return in the french market of silicone gel implants seems us an acceptable alternative.
盐水填充或水凝胶填充植入物的主要机械副作用是瘪陷。本研究的目的是分析图卢兹整形手术科室过去7年中假体瘪陷率。
我们追踪了1993年7月至2000年7月间接受手术的650例患者（共1117个初次植入物），将其分为两组：第一组为需要乳房重建的患者；第二组为因美观或乳房不对称原因植入假体的所有患者。对于两组中的每一组，我们确定了植入物的数量和类型，以及瘪陷发生的速率和平均延迟时间。
在此期间，我们确定：尽管植入物种类不同，但第1组（重建）的瘪陷率高于第2组（美观）；预填充水凝胶植入物的瘪陷率高于预填充盐水植入物的瘪陷率。
文献中仅描述了少数关于植入物瘪陷的系列研究。我们发现结果差异很大，从2%到76%不等。我们对本系列研究的结果感到惊讶，两组的平均随访时间为5年，在第四年之前的平均延迟时间，瘪陷率高达15%。瘪陷的因素众多：灭菌类型、波纹、质地、瓣膜功能不全、假体补片、保证控制和医源性原因。由于硅胶凝胶植入物（未出现瘪陷并发症的那种）已从法国市场撤出，盐水植入物试图取代它们，但效果并不理想。
鉴于我们研究中植入物不可接受的瘪陷率，硅胶凝胶植入物重返法国市场似乎是一个可接受的选择。
