A Rationale for Micro-textured Breast Implant Augmentation

A Multicentric and Retrospective Clinical Study: 2 Year Follow-up Results for Breast Surgery With Perle Smooth Opaque Silicone Breast Implants

Background

For breast surgery, there are a number of implants available that offer different options, such as shape, surface characteristics, gel fillers, and size/profile to meet the diverse needs of the patient population. Each implant option has its own advantages and disadvantages, and the individual patient's needs should be taken into account when making choices.

Objectives

To conduct an assessment of the safety, performance, and satisfaction rates through a 2-year follow-up study for the Perle mammary implant (Nagor Ltd, Glasgow, Scotland, United Kingdom).

Methods

A retrospective, observational, multicenter, noncomparative study was conducted from March 2023 to June 2023. The collection of data took place in 5 centers across France and Italy. Patients included in the study received the evaluated device between October 2020 and June 2021 for cosmetic and medical indications.

Results

Of the 97 patients included in the study, only 9 patients reported complications during the 2 years following the surgery. The overall complication rate was 9.28%. All patients and surgeons were satisfied or very satisfied with the surgery and the implant.

Conclusions

This patient cohort showed a rate of complications consistent with the range of other smooth implants after 2 years of follow-up and a high rate of both patient and surgeon satisfaction.

Level of Evidence 4

Management of second ipsilateral breast tumor event: An advocacy for a randomized trial

For a second ipsilateral breast tumor event, salvage mastectomy is the standard of care while second conservative treatment is a possible option. However, level 1 proofs are missing, leading to perform salvage mastectomy for patients who could receive second conservative treatment and consequently avoid psychological/quality of life salvage mastectomy deleterious impacts. A phase 3 randomized trial comparing salvage mastectomy to second conservative treatment is needed. Here we discuss what would be to us the optimal design of such trial to confirm the non-inferiority between the two salvage options, with a focus on methodological aspects in terms of patient characteristics and statistical issues.

Use of High-Resolution Ultrasound in Characterizing the Surface Topography of a Breast Implant

Background and Objectives: With the emergence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), it has become necessary to identify the implant shell type patients have received. Therefore, an immediate, reliable method for identifying a breast implant shell type is essential. Evidence-based research and applying a real-world technique that identifies the surface topographic information of the inserted breast implants, without surgery, has become of paramount importance for breast implant physicians. Methods and Materials: A review of the medical records of 1901 patients who received 3802 breast implants and subsequently received an ultrasound-assisted examination was performed. All patients received not only a breast cancer examination but also a high-resolution ultrasonography (HRUS) assisted examination of the device at a single center between 31 August 2017 and 31 December 2022. Results: Most patients had breast implants within 10 years (77.7%) of the examination. Of the 3802 implants screened, 2034 (53.5%) were identified with macro-textured shell topography in ultrasonography. A macrotextured shell type implant was used in 53.5% of cases and a smooth type in 42.7% of cases. Seventy-three (1.9%) breast implant shell types could not be identified due to ruptures. However, 250 breast implant shell types could be identified despite rupture cases (6.5%). Conclusions: HRUS was found to be a useful and reliable image modality for identifying various surface shell types of breast implants. The shell type information would be helpful to patients who lack information about their breast implants and are concerned about BIA-ALCL.