Breast Implants Research Articles

Breast Reconstruction: Focus on Implant-Based Reconstruction

Autologous tissue-based reconstruction and prosthetic implant-based reconstruction are the two main categories of breast reconstruction. The natural feel, size, and form of the breast can be restored by breast reconstruction with breast implants. Following a nipple- and skin-sparing mastectomy and a modified radical mastectomy, implant-based breast reconstruction is most readily executed. The most popular technique for immediate and delayed postmastectomy breast reconstruction is implant breast reconstruction, which makes use of silicone tissue expanders, which were initially utilized for breast reconstruction by Radovan in 1978 and Austad in 1979. As a sign of femininity, breasts might be lost, which can cause a woman great psychological discomfort and negatively impact her sexual life and self-image. Women are given the choice of breast reconstruction following a breast cancer removal treatment, which can enhance their quality of life. However, implant-based reconstruction ought not to be seen as an adjuvant treatment. Procedures like skin-sparing mastectomy and nipple-areola-sparing mastectomy, which enable conservative surgery with an instant implant breast reconstruction, can only be carried out with an early diagnosis.

The Problem of Diagnostic Criteria of Breast Implant Illness in Women After Breast Reconstruction: Review and Discussion of a Case.

There has been a rising trend in the use of silicone breast implants for breast reconstructions after breast cancer treatment, as well as in the aesthetic breast procedures. A cluster of non-specific symptoms related to the presence of silicone implant has been called breast implant illness (BII). However, there are no strict criteria of BII which would specifically define this term. The increasing interest in BII among patients and physicians urges verifying own cases of "on-demand" explantations. In this paper, we discussed a case of a patient with initial BII diagnosis, after breast reconstruction, and reviewed the literature on the BII symptoms and aetiology. A decision for aesthetic revision, not explantation, was made as the diagnosis of BII was questioned, and somatisation due to dissatisfaction with the aesthetic result of breast reconstruction was diagnosed. Improving aesthetics by implant exchange and contralateral mastopexy caused a full recovery from patient's symptoms. Based on our case, we point on the fact that BII diagnosis in patients after breast reconstruction is challenging. We suggest that while considering such a diagnosis and further proceedings, e.g. explantation, especially in patients after breast reconstruction, some exclusion criteria should be considered. Dissatisfaction with the result of the surgery can also lead to somatisation and the presence of real clinical symptoms, which should not be confused with the possible autoimmune reaction to silicone particles. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The effect of bra design on wearing appearance

PurposeEsthetic trend changes with the development of society and cultural differences. A minimizer bra designed to make breasts appear smaller is now popular with large-breasted women in China. To conform to the requirements of modern aesthetics in China, this paper aims to investigate vital features of breast appearance that influence people’s subjective evaluation of breast size and analyze how bra design parameters affect breast shape and make breasts appear smaller.Design/methodology/approachThis study used 3D scanning technology and reverse engineering software to obtain objective breast measurements in detail. A subjective evaluation experiment was conducted to evaluate the overall performance of seven minimizer bras compared to a basic comparison bra. Around 20 design parameters of 8 sample bras were identified to make a further study about the correlation between bra design features and breast shaping effect. To gain a deeper understanding of how bras interact with breast tissue, this study presented heat maps of the breast surface to visualize the deformation of breast shape.FindingsNine breasts' characteristics, such as the distance between bust points, breast depth, outer breast curvature and slope, etc. have been determined to be highly correlated with the visual reduction effect of breasts. In addition, for the bras in this experiment, the high-performance bra for women with large breasts tends to have a wider side panel, a wider under band, higher gore and a stronger transverse rigidity of the bra cup. According to the observation of heat maps of the breast surface, soft full-figure bras provide a wider range of compression to the breasts and effectively flatten the breasts.Originality/valueThis paper first aimed at the need to shape the ideal breast appearance for large-breasted women and make a further study of several hot-selling minimizer bras in China. The suggestions given in this paper help lingerie manufacturers better understand how design features of bras can affect their shaping effect and improve the wearing effect of minimizer bras for large-breasted women.

Autologous dura mater grafts in reconstructive surgeries for breast cancer: surgical and aesthetic outcomes

Background. Simultaneous breast reconstruction after subcutaneous or skin-sparing mastectomy using silicone implants is associated with a high risk of postoperative complications. Therefore, the issue of additional shell cover for breast implants is highly relevant. Synthetic and biological implants are believed to be the most effective.Aim. To assess the efficacy and safety of autologous dura mater grafts in reconstructive surgeries for breast cancer patients.Materials and methods. This study included 164 patients who had undergone subcutaneous or skin-sparing mastectomy with simultaneous breast reconstruction using implants and additional shell cover with either autologous dura mater grafts (experimental group, n = 83) or synthetic mesh implants (control group, n = 81) between 2017 and 2022. The mean patients’ age was 41.4 ± 7.2 years (41.2 ± 7.1 years in the experimental group and 41.6 ± 7.2 years in the control group). The mean follow-up time was 38.0 ± 21.4 months (min: 12 months; max: 80 months).Results. The 3-year relapse-free survival rate was 100 %. The 3-year progression-free survival was 97.4 % (95 % confidence interval 92.6–100.0 %). We observed no significant differences in the time to disease progression between the experimental and control group (p = 0.573). The assessment of aesthetic outcomes using a special surgical questionnaire showed excellent cosmetic and psycho-emotional results. Patients in both groups demonstrated comparable cosmetic results (p >0.05); however, psychoemotional satisfaction with surgery results was higher in the experimental group (p<0.05). Postoperative complications (primarily capsule contracture) were registered in 18 patients from the experimental group (21.7 %) and 31 patients from the control group (38.3 %) (p0.05). We also calculated the incidence rate ratio (IRR) and found that the difference was due to different follow-up time. Clinically significant capsule contracture was observed in 9 patients from the experimental group (10.8 %). The incidence of capsule contracture was higher among patients who had radiation therapy than in those who had no radiation therapy (15.8 % and 0.0 %, respectively; p<0.05).Conclusion. Subcutaneous or skin-sparing mastectomy with simultaneous breast reconstruction using silicone implants and autologous dura mater grafts is a safe and effective surgical method for breast cancer patients. The analysis of the international Breast-Q questionnaire results and surgical questionnaire results demonstrated that all patients had a high quality of life after simultaneous breast reconstruction using an autologous dura mater graft.

Specific characteristics and challenges associated with breast cancer diagnostics in women after breast augmentation and reconstructive surgeries with implants

Background. The number of plastic surgeries is constantly growing worldwide. Breast augmentation remains the most common surgical procedure in women, which demonstrated a 0.5 % increase over the past 4 years. As the number of women with breast implants increases, specialists and patients themselves face difficulties related to screening, diagnosis, and treatment of tumors, including breast cancer.Aim. To analyze specific characteristics of breast examination in patients after breast augmentation who were examined and treated in the mammological clinic of Russian Research Center of Radiology, Ministry of Health of the Russian Federation.Materials and methods. This study included 273 patients aged between 21 and 63 years (mean age 49.0 ± 7.6 years) after breast augmentation and after reconstructive surgery for breast cancer and symmetrizing surgery on the contralateral side. All women underwent clinical examination plus breast ultrasound (for patients under 40 years of age) or mammography followed by ultrasound (patients over 40 years of age). Patients who were found to have BI-RADS 3–4 tumors underwent ultrasound-guided or stereotactic breast biopsy. In case of suspicious intraductal formations according to breast nipple smears the patients were referred to breast ductography. Patients with suspected implant rupture or capsular contracture, as well as patients requiring the assessment of the disease stage underwent contrast-enhanced magnetic resonance imaging.Results. After comprehensive examination, 12 patients (5.4 %) were diagnosed with breast cancer; 38 patients (13.9 %), with implant rupture; 3 patients (1 %), with intraductal formations.Conclusion. Breast augmentation is not a contraindication to mammography in women aged over 40 years with glandular tissue. Additional examination methods include breast ultrasound, contrast-enhanced mammography, and breast magnetic resonance imaging. In case of no glandular tissue, contrast-enhanced breast magnetic resonance imaging and breast ultrasound are the methods of choice. It is important to develop new standards of screening and diagnosis of breast diseases in women after aesthetic surgery, since breast cancer incidence is likely to increase among women after breast augmentation over the next decades, considering the fact that breast cancer is the most common malignancy in women and its incidence is constantly growing.

Covalently grafted human serum albumin coating mitigates the foreign body response against silicone implants in mice

Implantable biomaterials and biosensors are integral components of modern medical systems but often encounter hindrances due to the foreign body response (FBR). Herein, we report an albumin coating strategy aimed at addressing this challenge. Using a facile and scalable silane coupling strategy, human serum albumin (HSA) is covalently grafted to the surface of polydimethylsiloxane (PDMS) implants. This covalently grafted albumin coating remains stable and resistant to displacement by other proteins. Notably, the PDMS with covalently grafted HSA strongly resists the fibrotic capsule formation following a 180-day subcutaneous implantation in C57BL/6 mice. Furthermore, the albumin coating led to reduced recruitment of macrophages and triggered a mild immune activation pattern. Exploration of albumin coatings sourced from various mammalian species has shown that only HSA exhibited a promising anti-FBR effect. The albumin coating method reported here holds the potential to improve and extend the function of silicone-based implants by mitigating the host responses to subcutaneously implanted biomaterials.

Impact of autologous breast reconstruction on bra fit.

To inform bra design by analyzing 3D surface images of breast cancer patients who underwent autologous breast reconstruction. We computed bra design measurements on 3D surface images of patients who underwent unilateral and bilateral autologous breast reconstruction. Breast measurements and right-left symmetry between preoperative baseline and postoperative time points were compared using either paired Student t-test or Wilcoxon signed-rank test, depending on the data's distribution. Regression analysis determined associations between measurements and patient characteristics such as age. Postoperative measurements and symmetry differences were also compared between autologous and implant-based breast reconstruction. Among participants who underwent bilateral autologous breast reconstruction, the reconstructed breasts were smaller and positioned higher on the chest wall than their native breasts. For patients who underwent unilateral reconstruction, similar postoperative changes were observed in the contralateral breast due to symmetry procedures. Overall, for participants whose baseline breast measurements showed substantial asymmetry, unilateral reconstruction decreased right-left asymmetry whereas bilateral reconstruction amplified right-left asymmetry. Preoperative baseline breast measurements, age, and BMI were statistically significantly associated with most postoperative breast measurements for participants who underwent bilateral autologous reconstruction. Compared to implant-based reconstruction, autologous reconstruction resulted in fewer changes in breast shape and symmetry that are pertinent to bra fit. Preoperative baseline breast measurements, age, and BMI can impact bra designs for breast cancer survivors who undergo autologous reconstruction due to size, shape, and symmetry changes. Bra needs of people who undergo autologous reconstruction differ from those who undergo implant-based reconstruction.

Contrast-enhanced breast imaging: Current status and future challenges

BackgroundContrast-enhanced breast MRI and recently also contrast-enhanced mammography (CEM) are available for breast imaging. The aim of the current overview is to explore existing evidence and ongoing challenges of contrast-enhanced breast imaging. MethodsThis narrative provides an introduction to the contrast-enhanced breast imaging modalities breast MRI and CEM. Underlying principle, techniques and BI-RADS reporting of both techniques are described and compared, and the following indications and ongoing challenges are discussed: problem-solving, high-risk screening, supplemental screening in women with extremely dense breast tissue, breast implants, neoadjuvant systemic therapy (NST) response monitoring, MRI-guided and CEM- guided biopsy. ResultsTechnique and reporting for breast MRI are standardised, for the newer CEM standardisation is in progress. Similarly, compared to other modalities, breast MRI is well established as superior for problem-solving, screening women at high risk, screening women with extremely dense breast tissue or with implants; and for monitoring response to NST. Furthermore, MRI-guided biopsy is a reliable technique with low long-term false negative rates. For CEM, data is as yet either absent or limited, but existing results in these settings are promising. ConclusionContrast-enhanced breast imaging achieves highest diagnostic performance and should be considered essential. Of the two contrast-enhanced modalities, evidence of breast MRI superiority is ample, and preliminary results on CEM are promising, yet CEM warrants further study.

Autoimmune/Inflammatory Syndrome Induced by Adjuvants

ASIA syndrome (autoimmune/inflammatory syndrome induced by adjuvants) is a group of autoimmune diseases caused by adjuvants that have the ability to induce immune responses. The syndrome includes five immune-mediated conditions that are associated with prior exposure to various trigger factors, such as siliconosis, macrophage myofasciitis syndrome, Persian Gulf syndrome, sick building syndrome, and post-vaccination autoimmune events. The development of ASIA syndrome is associated with an individual genetic predisposition and occurs as a result of the combined effect of exogenous and endogenous factors that trigger an autoimmune response. In this case, the reaction of the immune system can be unpredictable. The article presents the diagnostic criteria for the syndrome, as well as its clinical, laboratory and morphological manifestations. The spectrum of clinical manifestations of the autoimmune/inflammatory syndrome induced by adjuvants is extensive and affects almost all systems of the human body. At the same time, its characteristic feature is the regression of clinical, laboratory and morphological manifestations after removal of the adjuvant. There is no doubt that ASIA syndrome has clarified the role of adjuvants in the development of autoimmune processes. This should be taken into account when creating safe vaccines, silicone implants, fillers and other medical devices with minimal side effects. In addition, medical professionals should raise patients’ awareness of the side effects of using certain cosmetic procedures and the use of silicone implants, for which it is necessary to include a description of the etiology, pathogenesis, diagnosis and treatment of ASIA syndrome in teaching aids for students, residents and doctors of various specialties as a separate nosological unit.

Our Experience in Diagnosing and Treating Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T-cell lymphoma detected in association with textured implants. It presents as a fluid accumulation around the implant, usually years after the implantation. We present our experience in diagnosing and treating four patients with BIA-ALCL, each widely differing from the other. Data on patients' surgical history, relevant medical information, and findings on pathological slides were retrieved from their medical charts and retrospectively reviewed. Each of the four patients was diagnosed with BIA-ALCL, one after breast augmentation, one after breast reconstruction with an implant, one after breast reconstruction with a latissimus dorsi flap and implant, and the fourth after the removal of breast implants. The cases were presented to a multidisciplinary team and subsequently underwent surgery. All four are currently free of tumors, as established by a negative follow-up via positron emission tomography-computed tomography. Although the incidence of BIA-ALCL is rare, these cases emphasize the need to rule out the diagnosis of BIA-ALCL in patients with textured implants or a history of implanted textured devices who present with symptoms such as late seroma or peri-implant mass. This pathology is typically indolent and slow-growing and heightened awareness for an early diagnosis could lead to quicker intervention and enhanced patient management.

Subfascial Mini Muscle-Release Dual Plane Technique: A Modified Procedure for Breast Augmentation.

Each breast augmentation technique has advantages and indications, and the quest for the perfect implant pocket plane is ongoing. An ideal dual plane should meet three requirements: adequate implant coverage, optimal control of breast shape, and maximal muscle preservation. This paper reports a modified procedure for breast augmentation named subfascial mini muscle-release dual plane technique. From an inframammary or periareolar approach, the implant pocket is dissected in a subfascial plane up to the pectoralis major. The muscle is split 3 cm above the lateral margin and then pocket dissection proceeds in the submuscular plane. A small portion of the costal origin is divided inferomedially creating a dual plane. A total of 178 patients with hypoplasia or breast atrophy were included, among whom 34 had breast ptosis and 20 had tubular breast deformity. The median follow-up period was 20 months. With an average implant volume of 268.8 ml and a smooth implant type of 85.4%, there was 1 case of hematoma, 2 cases of wound healing issues, 2 cases of rippling sign, 2 cases of grade III/IV capsular contracture, 5 cases of implant malposition and 12 cases of mild muscle contraction-associated deformity. Revision surgeries were performed on 2 patients. The subfascial mini muscle-release dual plane technique is an easy method for breast augmentation and is especially indicated for ptotic breasts and tubular breast deformities. This technique combines the advantages of traditional dual plane and muscle-splitting techniques, yielding a satisfactory aesthetic outcome.

A Comparative Analysis of Local and Systemic Immunological Biomarkers in Females With Breast Implants and Capsular Contracture.

The etiology of capsular contracture (CC), the most common complication following breast augmentation, remains unclear. Chronic, fibrotic inflammation resulting in excessive fibrosis has been proposed as a potential mechanism. In this study, we aimed to investigate the relation between biomarkers that are associated with inflammation and fibrosis and the severity of CC. Fifty healthy females were categorized into 3 groups: females with no-to-mild CC (Baker 1-2; n = 15), females with severe CC (Baker 3-4; n = 20), and a control group awaiting breast augmentation (n = 15). We assessed 5 biomarkers (galectin-1 [Gal-1], interferon-β [INF-β], interferon-γ [INF-γ], interleukin-6 [IL-6], and tumor necrosis factor-α [TNF-α]) in breast implant capsules and serum samples. No significant differences in intracapsular cytokine levels were observed between the Baker 1-2 and the Baker 3-4 groups, as the levels were generally low and, in some cases, almost undetectable. In the blood samples, no significant differences in Gal-1, INF-γ, IL-6, or TNF-α levels were found within the 3 groups. We identified significantly increased levels of INF-β (P = .009) in the blood samples of females with severe CC, driven mainly by 3 extremely high values. The cytokines assessed in this study did not reflect the degree of CC among females with silicone breast implants. However, 3 females with severe CC, who all had prolonged silicone exposure, showed extremely elevated levels of INF-β in their serum samples. This possible association between prolonged silicone exposure and systemic inflammation in some females should be further investigated.

New Insights Into Breast and Chest Wall Asymmetry in the Aesthetic Patient

Abstract Background Asymmetry, a prevalent phenomenon throughout the human body, prompts this retrospective study, in which the authors aim at discerning potential patterns in its manifestation. Building upon our previous investigations in which left-sided chest wall and pelvic bone width surpassed their right-sided counterparts, a hypothesis is formulated suggesting the likelihood of the right breast being narrower and longer compared with the left. Objectives Our objective in this study is to investigate the correlation between the left-sidedness phenomenon in the chest wall and breast shape and appearance, with the aim of understanding its potential impact on outcomes in breast aesthetic surgery. Methods A random selection of pictures from 600 female patients undergoing various aesthetic breast procedures formed the basis of this study. Exclusion criteria involved the elimination of 254 pictures with nonstandard photography. Horizontal and vertical parameters of breasts and chest walls were measured, and the results on both sides were systematically compared to validate our hypothesis. Results On the left side, the chest wall, the distance between the nipple and the midline, and that of the nipple and the anterior axillary line were significantly wider. Vertical measurements, including the sternal notch to the nipple, the clavicle to the nipple, and the clavicle to inferior breast distance, although longer, did not exhibit statistical significance. Conclusions Approximately 77% of patients displayed wider breasts and chest walls on the left side. However, this observed asymmetry did not yield a statistically significant impact on the length of the breasts. Level of Evidence: 3 (Diagnostic)

The Reverse Dual Plane: A Novel Technique for Endoscopic Transaxillary Breast Augmentation.

Quite a few Asian patients prefer axillary incision for breast augmentation. However, this surgery needs improvement. To introduce a reverse dual-plane technique through a transaxillary approach and compare it with a transaxillary dual-plane approach. Eighty-two patients were divided into Group A (n = 40) and Group B (n = 42). Axillary incision and endoscope were utilized in the 2 groups. Tebbetts' dual plane was performed in Group A patients. Patients in Group B underwent our reverse dual-plane technique, in which the upper 70% was subfascial and the lower 30% was subpectoral, with the fascia of the external oblique and anterior serratus being elevated together with the pectoral muscle. The Numeric Pain Rating Scale (NPRS) scores were recorded daily for 7 days. Breast shape and softness, in both sitting and supine positions, were assessed by the patients, and complications were compared. The NPRS scores of Group B patients were significantly lower than those of Group A patients (P < .01). The satisfaction rate of shape and softness in the seated position was not significantly different (P > .05). However, in the supine position, only 20 patients (50.0%) in Group A and 32 patients (76.2%) in Group B were satisfied with their breast softness (P < .01), and the breasts of the others became stiffer. Breast animation deformity (BAD) occurred in 2 patients in Group A and in no patient in Group B (P < .01). Other complications were not significantly different. Compared with Tebbetts' dual plane, this procedure significantly reduced pain, improved breast softness, and eliminated BAD, without increasing complications.

A Comparison of Ovine-Reinforced Hybrid Mesh (OviTex PRS) With Porcine Acellular Dermal Matrix (STRATTICE) in the Treatment of Advanced Breast Implant Capsular Contracture.

Tissue reinforcement techniques with porcine acellular dermal matrices (ADMs) have been widely adopted as standard care in treating capsular contracture. However, the application of alternative xenograft or mesh materials has not been widely studied. To examine the efficacy of OviTex PRS Reinforced Tissue Matrix (Resorbable) (TELA Bio, Malvern, PA), a hybrid ovine-reinforced mesh, in comparison with STRATTICE Reconstructive Tissue Matrix (Allergan, Irvine, CA), in patients with advanced capsular contracture. A retrospective review was conducted on patients who underwent breast revision surgery for Baker Grade III or IV capsular contracture. Patient data were reviewed for outcomes, complications, cost, and postoperative incidence of recurrent capsular contracture after treatment with each specific mesh. Fifty-nine of 89 breasts (66.3%) were treated with OviTex and 30 (33.7%) were treated with STRATTICE. All patients experienced a reduction in Baker grades. In patients treated with OviTex, 96.6% (n = 57) of breasts had a postoperative Baker Grade I with the remaining 3.4% (n = 2) breasts presenting with a Baker Grade II. In comparison, 73.3% (n = 22), 23.3% (n = 7), and 3.3% (n = 1) of the STRATTICE cohort presented with Baker Grades I, II, and III, respectively. This demonstrated a statistically significant improvement in Baker grade capsular contracture in the OviTex cohort (P < .05) compared with STRATTICE. Average cost was $27.37/cm2 for STRATTICE compared with $22.28/cm2 for OviTex PRS. OviTex may be successfully utilized to treat capsular contracture. Patient outcomes may be superior to STRATTICE in recurrent capsular contracture, particularly when a previous ADM had been utilized. Cost data show improved savings with the use of OviTex compared with STRATTICE.

A Multicentric and Retrospective Clinical Study: 2 Year Follow-up Results for Breast Surgery With Perle Smooth Opaque Silicone Breast Implants.

For breast surgery, there are a number of implants available that offer different options, such as shape, surface characteristics, gel fillers, and size/profile to meet the diverse needs of the patient population. Each implant option has its own advantages and disadvantages, and the individual patient's needs should be taken into account when making choices. To conduct an assessment of the safety, performance, and satisfaction rates through a 2-year follow-up study for the Perle mammary implant (Nagor Ltd, Glasgow, Scotland, United Kingdom). A retrospective, observational, multicenter, noncomparative study was conducted from March 2023 to June 2023. The collection of data took place in 5 centers across France and Italy. Patients included in the study received the evaluated device between October 2020 and June 2021 for cosmetic and medical indications. Of the 97 patients included in the study, only 9 patients reported complications during the 2 years following the surgery. The overall complication rate was 9.28%. All patients and surgeons were satisfied or very satisfied with the surgery and the implant. This patient cohort showed a rate of complications consistent with the range of other smooth implants after 2 years of follow-up and a high rate of both patient and surgeon satisfaction.

Preservation of breast ligamentous structures in mastopexy: achieving aesthetic excellence with minimal complications

Background: Breast ptosis has traditionally been addressed through mastopexy techniques, but there is an increasing focus on preserving breast anatomy to minimize complications. This includes conserving critical ligamentous and fascial structures, considering that traditional techniques may lead to loss of support and adverse outcomes. Objective: The study aims to introduce a novel mastopexy technique that prioritizes ligament preservation, with the option to include breast implants, emphasizing patient safety and exceptional aesthetic outcomes. Design: The study design included a descriptive statistical analysis of a novel mastopexy technique applied to 138 patients with a minimum 1-year follow up, performed by a single surgeon in San José, Costa Rica, from August 2020 to September 2022. Preoperative measurements, breast implant data, and postoperative outcomes were described. Results: A total of 138 patients who underwent preservation mastopexy were analyzed. The median age was 39 years (interquartile range [IQR] 33 – 45) with a 28-month median follow-up. Preoperative measurements included a median nipple-to-inframammary fold distance of 9.5 cm (IQR 8 – 11) and a base diameter of 10.5 cm (IQR 10 – 11). Major complications included one readmission for hematoma drainage (0.7%), no major flap or nipple loss, and minor issues involving dog ears (1.4%) and hypertrophic scars (1.4%) requiring revisions. No seroma or implant-related complications were reported. Discussion: This study’s innovative mastopexy technique prioritizing breast ligament preservation, with or without adjunctive implants, achieved excellent aesthetics and low complications. This approach, aligned with personalized breast surgery principles, demonstrates the significance of preserving ligamentous support and natural breast architecture. Safety concerns were effectively addressed, emphasizing the technique’s ability to reduce adverse events, substantiated by statistical evidence and earlier studies. Conclusions: This study demonstrates a low complication rate and favorable aesthetic outcomes with a novel mastopexy technique that prioritizes breast ligament preservation. It utilizes breast implants when needed as an addendum to preexisting breast tissue, basing its selection on objective measurements and overall body proportions.

Ultrasonic elastography for the prevention of breast implant rupture: Detection of an increase with stiffness over implantation time

Breast implants are widely used after breast cancer resection and must be changed regularly to avoid a rupture. To date, there are no quantitative criteria to help this decision. The mechanical evolution of the gels and membranes of the implants is still underinvestigated, although it can lead to early rupture. In this study, 35 breast explants having been implanted in patients for up to 17 years were characterized by ex vivo measurements of their mechanical properties. Using Acoustic Radiation Force Impulse (ARFI) ultrasound elastography, an imaging method for non-destructive mechanical characterization, an increase in the stiffness of the explants has been observed. This increase was correlated with the implantation duration, primarily after 8 years of implantation. With an increase of the shear modulus of up to a factor of nearly 3, the loss of flexibility of the implants is likely to lead to a significant increase of their risk of rupture. A complementary analysis of the gel from the explants by mass spectrometry imaging (MSI) and liquid chromatography coupled to high resolution mass spectrometry (LC-HRMS) confirms the presence of metabolites of cholesterol originating from the breast tissues, which most likely crossed the membrane of the implants and most likely degrades the gel. By observing the consequences of the physical–chemical mechanisms at work within patients, this study shows that ultrasound elastography could be used in vivoas a quantitative indicator of the risk of breast implant rupture and help diagnose their replacement.

Unusual findings on MRI of patients with breast implants

Unusual findings on MRI of patients with breast implants

Results of a patient survey using an online questionnaire after implant removal for breast implant illness.

The use of silicone breast implants has a history of over 60 years. In recent years, specific health issues among implant wearers have repeatedly come into focus. The term "breast implant illness" has been circulating in scientific literature and on social media for several years. It describes a cluster of up to 60 different symptoms. The present results of an online survey conducted within a clinic's patient population of the last 8 years show, among other things, the evolution of 8 reported symptoms before and after breast implant removal. In the comparison before and after, there is a significant reduction in the intensity of symptoms after implant removal. A causal relationship with the removal of the implants is to be presumed.