Transumbilical Silicone Breast Augmentation: A 13-Year Experience and 5-Year Analysis.

BACKGROUND: Transumbilical breast augmentation (TUBA) with saline implants has been considered a safe and efficient technique for decades. However, because silicone implants are more popular than saline ones, TUBA with saline implants is not widely performed. In 2014, we published a report on transumbilical breast augmentation using silicone cohesive gel implants. As we have performed transumbilical silicone breast augmentation (TUSBA) for 13 years with slight modifications, this study aimed to describe this novel technique and present accompanying patient outcomes over 5 years. METHODS: We enrolled patients desiring breast augmentation at a single center. The preoperative design was initially determined with the patients in standing positions before they underwent surgery under general anesthesia in a supine position. RESULTS: Between January 2018 and December 2022, 69 women and one man underwent TUSBA at a single center. All patients underwent cohesive gel silicone implantation in the subpectoral pocket. The implant size varied from 225 to 300 mL (average 272 mL) because two patients underwent surgery with implants of different sizes due to breast asymmetry. All patients were satisfied with the surgery outcome except one who was dissatisfied because of abdominal bulging. CONCLUSIONS: TUSBA offers advantages such as minimal scarring and unrestricted arm movement; thus, it can be an alternative option for patients seeking breast augmentation. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .

Does Overfilling Smooth Inflatable Saline-Filled Breast Implants Decrease the Deflation Rate? Experience with 4761 Augmentation Mammaplasty Patients.

BACKGROUND: Research suggests that overfilling saline inflatable breast implants may decrease their deflation rates. To date, there has been no large-scale study comparing breast implants filled within vs. beyond the manufacturer's recommended fill volumes. METHODS: A retrospective comparative study was conducted for 4761 women who underwent aesthetic augmentation mammaplasty by the author. Patients were divided into two groups: Group 1 includes 2960 patients who had breast augmentation between 2002 and 2009 with implants filled within the manufacturer's recommended fill volumes. Group 2 includes 1801 patients who had breast augmentation between 2011 and 2018. Their implants were overfilled with an average volume between 42 and 50 cc, or 10-13%, respectively. All surgeries were performed with Mentor Style 1600 saline breast implants (smooth, round moderate profile) through an inframammary incision; implants were placed in the subpectoral (dual) plane. Also evaluated was the yearly increase in deflation rates. RESULTS: Group I had 119 deflations, representing a deflation rate of 4.02%. Group 2 had 33 deflations, providing a deflation rate of 1.83%. The author found a protective effect in overfilling the device (p < 0.00001 and Z-score of 4.17). Fold failure was the major reason for deflation in both groups. The implants filled within the manufacturer's recommended volume had a yearly increase in deflation rate of 0.41%, not 1% as is commonly reported. The overfilled implants did not have a yearly increase in deflation rate. CONCLUSION: Overfilling Mentor Style 1600 saline breast implants (smooth, round moderate profile) 10-13% significantly reduced the deflation rate. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A 10-Year Follow-Up Experience of 383 Patients with Bilateral Smooth Inflatable Breast Implants Filled with Saline Solution.

INTRODUCTION: In light of the concerns regarding the occurrence of anaplastic large-cell lymphoma, seromas, and scar capsules, there appears to be merit in analysis and presentation of the results of our series of inflatable smooth implants filled with saline solution, for which the follow-up was more than 10 years. PATIENTS AND METHOD: We carried out a retrospective study, including all of the patients who underwent a first breast implant for cosmetic reasons, between 2003 and 2006. RESULTS: A total of 383 patients with 766 smooth implants filled with saline solution were included in our study. No cases of lymphoma and seroma were diagnosed. Eleven patients exhibited a postoperative hematoma, and four went on to develop a capsule. Twenty-two patients (5.7%) developed a Baker Grade III or IV capsule that required revision surgery. Two patients (0.5%) opted for a bilateral prosthesis replacement due to visual rippling. In total, there were 26 (3.4%) early deflations of prostheses. DISCUSSION: There is not a statistically significant correlation between the occurrence of hematomas and the formation of a capsule. We found a lower shell rate with smooth-walled versus textured implants. The fact of having a decline of 10 years allows to be exhaustive. As for wrinkling and ripples, their occurrence has not been increased by the use of inflatable retropectoral implants. CONCLUSION: Smooth inflatable implants filled with saline solution have numerous advantages such as the possibility of a very small approach route and perioperative adaptability of the volume. In light of the lack of indication of anaplastic large-cell lymphoma with smooth implants, they are clearly an attractive alternative to textured implants filled with silicone gel. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.