International Expert Panel Consensus on Fat Grafting of the Breast.

BACKGROUND: Autologous fat grafting has broad applications in reconstructive and aesthetic breast surgery as a natural filler and for its regenerative purposes. Despite the widespread use of fat grafting, there remains no shared consensus on what constitutes the optimal fat grafting technique and its oncological safety. For this reason, the authors of this study have organized a Survey and an International Consensus Conference that was held at the Aesthetic Breast Meeting in Milan (December 15, 2018). METHODS: All studies on fat grafting, both for breast aesthetic and reconstructive purposes, were electronically screened. The literature review led to 17 "key questions" that were used for the Survey. The authors prepared a set of 10 "key statements" that have been discussed in a dedicated face-to-face session during the meeting. RESULTS: The 10 key statements addressed all the most debated topics on fat grafting of the breast. Levels of evidence for the key statements ranged from III to IV with 2 statements (20%) supported by a level of evidence III and 6 statements (60%) by level of evidence IV. Overall consensus was reached for 2 statements (20%) with >75% agreement reached for 7 statements. CONCLUSIONS: The survey demonstrated a diversity of opinion and attitude among the panelists with regard to technique. Clear recommendations for evidence-based clinical practice for fat grafting use both in aesthetic and reconstructive breast surgery could not be defined due to the scarcity of level 1 or 2 studies.

Usefulness of Radio Frequency Identification Device in Diagnosing Rotation of Motiva SmoothSilk Implants after Augmentation Mammoplasty.

Breast implant displacement has been described as a significant risk following augmentation mammoplasty. Magnetic resonance imaging (MRI) is considered the method of choice for diagnosing implant complications, but it has its limits in assessing correct implant position and displacement. Motiva SmoothSilk/SilkSurface® Implants (MSS) are the first to incorporate a radio frequency identification device (RFID), which produces an imaging artifact in MRI sequences. Given the frequency of breast augmentation procedures and the recent US Food and Drug Administration prospective trial involving SS with RFID, further analysis of implant stability and diagnostic imaging methods to evaluate implant positioning is necessary. The objective of this study was to assess the use of MRI with this new RFID-containing implant as a new tool to assess correct implant positioning. The authors performed this technique in 5 patients (10 implants) undergoing primary breast augmentation or revision surgery with MSS implants (255-385 cc, mean = 325 cc). The average area and volume of the artifact were 15.7 cm2 and 31.75 cm3, respectively. All cases presented satisfactory results, with 1 case of implant displacement. Our clinical and radiological outcome demonstrated that RFID technology is a useful tool for correct visualization of the implant position and diagnosis of complications such as slight displacements or rotation. To our knowledge, this is the first RFID breast implant that has been objectively evaluated for MRI issues.

Nanotechnology, nanosurfaces and silicone gel breast implants: current aspects.

Nanotechnology is defined as the design of products that interact with biological systems on the nanoscopic scale. Creating a controlled nanotexture and understanding the ways in which surface properties impact inflammatory response is of the utmost significance in designing implants that can provide satisfactory outcomes.