Poly implant prothèse (PIP) breast implants: our experience.

ABSTRACT

INTRODUCTION: This study describes our experience on the management of patients with PIP (Poly Implant Prothèse) breast implants between 2000 and 2008. MATERIALS AND METHODS: The medical records of patients were reviewed. Data was collected on clinical presentation, investigations, management and outcome. RESULTS: 44 patients, with bilateral breast implants, and a median age of 33 years (18-54 years), were reviewed, and of these, 31 patients were asymptomatic. Symptoms at presentation included lymphadenopathy, capsule formation, breast lump, seroma and breast pain. Patients underwent mammography, ultrasound and MRI scanning of the breasts as part of the imaging investigations. 5 patients declined explantation. Reasons for explantation included patient anxiety, silent rupture, aesthetic breast change, palpable nodes and breast lump. 17 out of a total of 78 implants (21.8%) were noted to have ruptured; 2 had a simple tear and 15 were totally disintegrated. 1 patient underwent removal of the implants, 18 underwent exchange of implants, and 20 patients had a capsulotomy and exchange of implants. Postoperative complications included wound infection, seroma, axillary lymphadenopathy, hypersensitive scar and overgranulation of the wound. CONCLUSION: Our series confirms the high rate of PIP implant rupture (21.8%), the majority of which were asymptomatic. The main reasons for explantation were patient anxiety and silent rupture of implants. It is imperative that patients should be appropriately counselled, prior to surgery with regards to removal of the implants, given the increased rupture rates noted.