Saline-filled breast implants: a Plastic Surgery Educational Foundation multicenter outcomes study

Area of Science:

• Plastic Surgery
• Biomaterials Science
• Medical Device Outcomes

Background:

• Saline-filled breast implants have been widely used for augmentation and reconstruction.
• Understanding long-term outcomes and patient-reported data is crucial for informed decision-making.
• Previous studies may not fully capture complication rates and patient satisfaction.

Purpose of the Study:

• To evaluate the outcomes of saline-filled breast implants using physician- and patient-reported data.
• To identify risk factors for implant deflation and capsular contracture.
• To assess overall patient satisfaction and likelihood of re-choosing the implants.

Main Methods:

• Retrospective cohort study involving 11 centers and 504 patients with 995 saline-filled breast implants.
• Data collected on implant placement between 1980 and 1989, with a mean follow-up of 6 years.
• Analysis included reoperation rates, complication incidence, implant deflation, capsular contracture, and patient satisfaction.

Main Results:

• 20.6% of patients required reoperation; 5.5% of implants deflated, with underfilling as a key risk factor.
• 20.4% experienced significant capsular contracture, associated with omitting intraluminal antibiotics/steroids and submammary placement.
• 94.2% reported high satisfaction, and 94.8% would choose saline implants again, though dissatisfaction linked to breast firmness and desired size.

Conclusions:

• Saline-filled breast implants are a safe alternative to silicone gel-filled implants, offering high patient satisfaction.
• Avoiding underfilling is critical to prevent deflation; intraluminal antibiotics/steroids reduce contracture but increase deflation risk.
• Subpectoral placement decreases capsular contracture, and patients should be informed about potential reoperations.