Augmentation Mammaplasty with Saline-Filled Textured Implants: Review of 9 Years' Experience and Results of Patient Survey

Abstract

Introduction: In June of 2000 the FDA approved saline-filled breast implants as safe prosthetic devices based on results of clinical testing presented by the manufacturers. The corresponding author has been using saline-filled implants since 1992. It was decided to review his experience and assess the incidence of postoperative complications as reported by the patients and to identify factors related to their satisfaction. Materials and Methods: A survey was mailed out to a cohort of 460 patients. The survey included questions pertaining to possible postoperative complications and the patient's overall satisfaction. Overall, 207 surveys were returned after 2 mailings. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software. Results: The patient's age at the time of surgery ranged from 18 to 62 years, with a mean of 33.8 years. Follow-up time ranged from 6 months to 102 months postoperatively, with a mean of 37.2 months. Forty-two out of 193 patients were smokers. Implant volumes ranged from 180 to 800 mL, with an average of 380 mL. Implant types used were McGhan (55.5%), Mentor (40.5%), and Microcell (4%). All implants had surface texturing. Most of the implants (90.7%) were placed in a submuscular position. Sixty-five percent of the patients preferred a transaxillary approach, whereas 35% preferred the periareolar approach. Discussion: Capsular contracture remains one of the main factors affecting patient satisfaction. Implant volume and position had no significant effect on the risk of developing capsular contracture. Furthermore, the volume of an implant did not have a significant impact on the risk of developing pain, loss of nipple sensation, or wrinkling. In this study, a significant number of patients reported wrinkling (44.4%) and alteration of nipple sensation (40.6%), which reflects the fact that this is a subjective patient-reported result. Overall satisfaction rate reported was 96.6%.