Results of reaugmentation with MISTI prostheses after failure of smooth silicone prostheses

In 1988 and 1989, we replaced smooth silicone double-lumen implants with Molecular Impact Surface Textured Implants (MISTIs) in 28 of our patients. Of these, 20 had experienced recurrent capsular contracture and sought an alternative prosthesis that would provide long-term relief from this problem, and 8 simply wanted larger prostheses. Among the reaugmentation patients who had experienced recurrent contractures, 4 have had problems with the texturized implants; 1 developed an infection, and 3 developed unilateral fibrosis within weeks of surgery. The infection was resolved with antibiotics, and the fibrosis was resolved with capsulectomy, biweekly methylprednisolone irrigation in the surgical pocket, and lenticular suction drainage over a 3-week period. After a 2-year follow-up, these 4 problematic patients have remained soft and asymptomatic following their treatment, and the remaining 16 patients have remained soft and asymptomatic since their surgery.