Soft cohesive silicone gel breast prostheses: a comparative prospective study of aesthetic results versus lower cohesivity silicone gel prostheses.

The flexibility of lower cohesivity silicone prostheses is the main reason for wrinkling, rippling and evidence of implant edges. The soft cohesive silicone implants promise to minimize such effects with minimal softness reduction. Forty consecutive patients received soft cohesive prostheses (INAMED Style 110 ST) and were studied prospectively. A historical group, made up by the 40 consecutive patients who received lower cohesivity silicone implants (INAMED Style 110) in the immediately preceding months, was used as a control. Wrinkling, prosthetic edge perceptibility and capsular contracture degree were assessed six months after surgery. The tissue coverage thickness was measured using ultrasonography. The patients were then asked to evaluate the breast softness by means of an anonymous questionnaire, where they also expressed their overall satisfaction by means of the five-steps linear analogical scales. The wrinkling prevalence was 9.2% in the soft cohesive group vs. 55% in the lower cohesivity one (p<0.01). The edge perceptibility was 14% in the soft cohesive group vs. 22% in the lower cohesivity one (no statistical significance). The coverage tissue thickness was not found to be significantly related to the wrinkling prevalence or to the edge perceptibility. The capsular contracture rate was almost identical in the two groups (Baker II: 2.6% vs. 2.7%, no Baker III or IV). A higher stiffness was noted in the soft cohesive group (average score: 4.2 vs. 4.4 in the control group, p<0.05), but the overall satisfaction degree was higher for soft cohesive implants (average score: 4.5 vs. 3.8, p<0.01). The soft cohesive prostheses offered better overall results than the lower cohesivity silicone prostheses, even if a longer term follow-up should be advised. The soft cohesive prostheses showed a higher firmness, but this seemed not to have any influence on the overall satisfaction degree.