Endoscopic plastic surgery: the endoscopic evaluation of implants after breast augmentation.

There is an ongoing discussion about the possible connection of gel-filled silicone implants for breast augmentation and the development of connective tissue disease. In the absence of any proven link and irrespective of the difficulty to prove such a causality, these discussions lead to great concern for the hundreds of thousands of women who underwent breast augmentation with silicone gel implants. As a consequence there are voices that call for regular checks of the implants with regard to their integrity. All the external methods of judging an implant, including MRI, can--if at all--detect only marked lesions or ruptures. Direct visualization of the implant up to now has been the only safe method. Direct visualization can be carried out by reopening the previous incision or by endoscopic inspection. Endoscopic evaluation needs the dexterity of all endoscopic plastic surgery procedures, but with sufficient training and experience it is a very safe, quick, and highly compliant procedure for the patient and can be combined with endoscopic biopsies and other endoscopic operations such as capsulotomies.