Haws Melinda J, Alizadeh Kaveh, Kaufman David L
Dr Haws is a plastic surgeon in private practice in Nashville, Tennessee. Dr Alizadeh is a plastic surgeon in private practice in Great Neck, New York. Dr Kaufman is a plastic surgeon in private practice in Folsom, California.
Aesthet Surg J. 2015 May;35 Suppl 1:S33-42. doi: 10.1093/asj/sjv021.
Rupture of silicone gel breast implants is a rare occurrence but remains one of the key surgical concerns. The objective of this article was to provide visibility and information on trends for the impact that patient and surgical characteristics play in the occurrence of rupture.
Examine trends in surgical techniques to better understand the etiology of implant rupture.
Analysis was based on Sientra's prospective, open-label, U.S.-based clinical study of High-Strength Cohesive silicone breast implants. Patient and surgical characteristics were compared between ruptured and intact implants.
The subset of data used for this analysis included 1792 implants in 935 primary and revision augmentation patients implanted by 31 plastic surgeons, with an average follow-up of 6.6 years. The results confirm that rupture remains a rare adverse event. Overall, the rupture prevalence for this study was 2.4%. Rupture prevalence was lower among textured devices (0.8%) compared to smooth devices (3.8%). The prevalence of rupture was 7.8% among devices placed with a transaxillary incision site compared to 1.6% and 3.0% when placed with an inframammary or periareolar incision site, respectively. Rupture was reported in 5.5% of the devices that received steroid pocket irrigation, compared to 1.8% of the devices that did not.
Although ruptures in the Sientra study with the High-Strength Cohesive silicone gel implants were an uncommon occurrence, the authors were able to identify strong trends for the association of certain surgical factors and characteristics. The results show among other factors that an inframammary approach and a textured device were found to be protective against rupture.
2 Therapeutic.
硅胶乳房植入物破裂是一种罕见情况，但仍是主要的手术关注点之一。本文的目的是揭示并提供有关患者和手术特征在破裂发生中所起作用的趋势信息。
研究手术技术趋势，以更好地理解植入物破裂的病因。
分析基于Sientra公司在美国进行的一项关于高强度凝聚硅胶乳房植入物的前瞻性、开放标签临床研究。对破裂和未破裂的植入物的患者及手术特征进行比较。
用于该分析的数据子集包括由31名整形外科医生为935名初次和翻修隆乳患者植入的1792个植入物，平均随访6.6年。结果证实破裂仍然是一种罕见的不良事件。总体而言，本研究的破裂发生率为2.4%。与光滑表面的植入物（3.8%）相比，纹理表面的植入物破裂发生率较低（0.8%）。经腋下切口植入的植入物破裂发生率为7.8%，而经乳房下皱襞或乳晕周围切口植入的发生率分别为1.6%和3.0%。接受类固醇囊袋冲洗的植入物中有5.5%报告发生破裂，未接受冲洗的为1.8%。
尽管在Sientra公司关于高强度凝聚硅胶植入物的研究中破裂情况并不常见，但作者能够确定某些手术因素和特征之间关联的明显趋势。结果显示，除其他因素外，乳房下皱襞入路和纹理表面的植入物具有防止破裂的作用。
2级治疗性。
