Capsular contracture is
the most common complication associated with breast implant
surgery. This is where the membrane, which grows around
all implants and normally can’t be seen or felt,
behaves like ‘shrink wrap’. This compresses
the implant, causing it to feel firm or hard and often
distorting its shape. Capsular contracture is the biggest
cause of patient dissatisfaction and the need for further
surgery.
Evidence submitted to the regulatory authority in the
United States, the FDA, showed that within 7 years of
breast implant surgery around 16% of patients had developed
capsular contracture with both smooth and textured surfaced
implants. To correct this, further surgery is needed.
How can it be
reduced?
There are now implants
available in the UK which reduces this problem dramatically.
Manufactured in Brazil by Silimed, they are approved in
many countries including the UK. Brazilian implants are
cohesive silicone gel implants with a polyurethane foam
surface which reduces the risk of capsular contracture
to around %1.9.
Are they new?
This type of implant is
not new. They were fi¬rst used in 1968 and there is
more than 40 years of data showing that these implants
are safe. Since 1970 there have been more than 100 papers
and articles published in learned journals around the
world about the use of these implants. These papers have
con¬firmed their safety and reduced rate of capsular
contracture.
How do they work?
When the Brazilian implants
are used in breast implant surgery, the foam covering
becomes part of the capsule. It acts as a scaffolding
or lattice, which the collagen ¬fibre (that makes
up the capsule) wraps themselves around. They are stabilised
and no longer lined up end on end, as seen in the capsules
of smooth and textured implants. The fi¬bres are unable
to slide over one another so the capsule is much less
likely to contract like shrink wrap.
Can these implants
move?
The unique surface of
the polyurethane foam-covered implant grips to the capsule
like Velcro, reducing the risk of displacement and rotation.
In fact, these implants are guaranteed not to rotate which
means the option of teardrop shaped implants can be chosen
without the fear of rotation.
What do the experts
say?
Dr Guillermo Vasquez,
a plastic surgeon from Argentina, reported his experience
using these implants in 1,257 patients over an 18 year
period. He concluded: ‘Polyurethane coated silicone
gel implants… are the option for augmentation mammoplasty
and have the lowest incidence of fi¬brous capsular
(1%) with these implants.’ Vazquez, G Polyurethane-Coated
Silicone Gel Breast Implants Used for 18 years. Aesthetic
Plastic Surgery 2007.
Leading American breast implant surgeons also favour polyurethane
foam implants: ‘During the span of this author’s
practice, he has never been able to match the number and
quality of superior results exemplifi¬ed by these
patients when using other devices.’ Hester T.R.,
Tebbets, J Maxwell, G.P. The Polyurethane covered mammary
prosthesis: Facts and ¬ction (II). Clinics in Plastic
Surgery Vol28 2001.
