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Updated: Jun 4, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction

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A 15-year experience with primary breast augmentation.

Mark A Codner1, Juan D Mejia, Michelle B Locke

  • 1Atlanta, Ga.; and Medellin, Colombia From the Division of Plastic and Reconstructive Surgery, Emory University; private practice; and Paces Plastic Surgery.

Plastic and Reconstructive Surgery
|March 3, 2011
PubMed
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Implant-specific reoperation rates offer a clearer view of breast implant complications than total reoperation rates. This study found no difference in implant-specific reoperation between saline and silicone breast implants.

Area of Science:

  • Plastic Surgery
  • Biomaterials Science
  • Medical Device Evaluation

Background:

  • Evaluated 812 patients undergoing primary breast augmentation or augmentation/mastopexy between 1994-2009.
  • Reoperations categorized into total and implant-specific reasons.
  • Hypothesized implant-specific rates accurately reflect device-related complications.

Purpose of the Study:

  • To compare the accuracy of total reoperation rates versus implant-specific reoperation rates in assessing breast implant complications.
  • To determine if silicone implants have higher complication rates than saline implants.

Main Methods:

  • Retrospective analysis of 812 patients receiving the same brand of breast implants.
  • Calculated complication rates including capsular contracture, rippling, rupture, infection, and hematoma.

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Last Updated: Jun 4, 2026

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  • Utilized Kaplan-Meier cumulative incidence calculations for statistical analysis.

    • Main Results:

    • Included 482 saline and 330 silicone implants; common complications were capsular contracture and rippling.
    • By 6 years, 8.2% developed Baker grade III/IV capsular contracture; 7.1% experienced rippling.
    • Total reoperation rate at 1 year was 14.2%; silicone implants showed higher total reoperation rates (p < 0.01), but no difference in implant-specific reoperation rates (p = 0.582).

    Conclusions:

    • Total reoperation rates can overestimate implant-related issues and inaccurately suggest higher silicone implant complication rates.
    • Implant-specific reoperation rates provide a more precise measure of device-related complications.
    • No significant difference in implant-specific reoperation rates between saline and silicone implants was observed.