American Journal of Cosmetic SurgeryIn a recent edition of the American Journal of Cosmetic Surgery, the results of 9 years experience using saline filled breast implants at The Facial Plastic & Cosmetic Surgical Center were reported. In addition to reviewing results of surgery, an analysis of patient response to the surgery was studied. Capsular contracture, or firmness, remains one of the main factors affecting patient satisfaction.

In addition to patient chart review, a survey was mailed out to 460 patients to assess overall satisfaction with the surgery and to study complications. Most of the patients had their implants placed in the submuscular position, which remains the position chosen by most patients at our Center.

Overall, 19% of patients reported firmness in their breasts. The firmness began anywhere from two weeks after surgery up to three years. Most patients elected against correction while about 8% of those with firmness chose to have it corrected surgically.

Deflation occurred in 4% of patients over the course of study. The incident occurred anywhere from two weeks to six years following surgery. In all cases, the deflation was spontaneous, and no patient could relate it to any type of injury or trauma. Most patients had their implants replaced within a week of deflation.

Rippling occurred more frequently than was anticipated. 44% of patients were aware of rippling or wrinkling of the implant. Fortunately, in most cases this was limited to the area of the fold beneath the breast and was felt much more commonly than seen. Also somewhat surprising was the high incidence of numbness and change in nipple sensation. While this has been reported in previous studies, it is often overlooked and patients considering this surgery should be aware of the possibility of permanent change.

In spite of problems reported by a significant percentage of patients, the satisfaction rate of patients is high with only 7% reporting dissatisfaction with the result of surgery and 91% of patients reporting that they would choose to have the surgery again.

The full text of the article is available in pdf format by saline.