ASSESSMENT AND LONGEVITY OF THE SILICONE GEL BREAST IMPLANT

Many patients are now consulting plastic surgeons for evaluation of th eir silicone gel breast implants. This study assesses the accuracy of a clinician's ability to determine if a silicone gel breast implant ha s failed. In addition, it sheds light on the long-term integrity of th e silicone gel breast implant. This study examined the condition of 35 0 silicone gel breast implants in a group of 159 of the authors' patie nts who previously had undergone augmentation mammaplasty or breast re construction. These women underwent secondary open procedures includin g capsulotomy or capsulectomy for fibrous capsule contractures, exchan ge of implants, or other revisional surgery. The condition of the impl ant was noted at the time of this secondary operation. The preoperativ e evaluation, which included the patient's history and physical examin ation and often mammography, was then matched against the operative fi ndings to determine the pertinent factors that predict the integrity o f a silicone gel breast implant. A history of trauma and/or a reported change in shape of a patient's breast correlated with implant failure . An analysis of implant failure as a function of implant age revealed that 63 percent of silicone gel breast implants in place 12 years or greater in this study population were not intact. A change in the pati ent's physical examination, including a softened breast consistency an d/or the presence of a nodule or mass adjacent to an implant, also was suggestive of implant failure. Several different mammographic present ations of implants that were not intact were identified. This modality predicted implant failure in 89 percent of implants studied. It is ho ped that this information will help clinicians to make a more accurate assessment of the condition of a patient's silicone gel breast implan t. It should be noted that all women in our study underwent secondary procedures, as stated above. The results obtained apply to this patien t group but may not specifically pertain to the general implant-bearin g population.