USE OF SILICONE IMPLANTS AFTER WIDE LOCAL EXCISION OF THE BREAST

The appearance of the breast after wide local excision for carcinoma m ay be unsatisfactory. In 59 patients undergoing wide local excision a silicone prosthesis was inserted into the cavity at the time of primar y surgery. Assessment of the cosmetic result was performed after 12 .m onths by questionnaire and clinical examination. Four prostheses were removed within 1 year because of infection (two patients), wound break down (one) and pain (one). Seven prostheses were subsequently removed because of severe capsular contraction. Capsular contraction was more common in patients who had received radiotherapy. Only 23 patients fou nd the results of the implant acceptable or satisfactory. The immediat e use of intramammary implants after wide local excision is currently associated with a poor cosmetic result, and the problem of the distort ed breast after such excision requires continued attention.