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Is there a connection between size and complications

Article-Is there a connection between size and complications

Rochelle Nataloni
Staff Correspondent

A study of the safety of implants measuring more than 350 cc to 400 cc by Robert Centeno, M.D., and colleagues found that larger-volume implants do not cause more complications or re-operations than smaller implants after investigating more than 270 primary augmentation patients.

Some surgeons strongly oppose the use of breast implants larger than 350 cc to 400 cc. In his practice, however, Dr. Centeno reported, patients want larger sizes, and this desire has been accommodated because no data has shown them to be contraindicated. His prospective study is the first to investigate the volume issue in a systematic way, and it indicates that larger-volume implants do not seem to cause more complications or re-operations than smaller-volume implants, Dr. Centeno reported.

Of the study’s 276 primary augmentation patients, 31 (11 percent) had 35 revisional procedures on 47 breasts. Eighteen breasts had a revision with no implant exchange, 23 received a new implant and 4 breasts underwent explantation only, with 2 being re-augmented at a later time. A total of 575 saline implants were implanted. Their fill volumes ranged from 225 cc to 775 cc, with a mean volume of 445 cc. The re-operation frequency for implants filled with < 350 cc was nearly twice as high as that for implants filled with≥600 cc (18.3 percent vs. 9.5 percent, respectively). However, the average follow-up time for smaller implants was nearly six months longer than for larger implants. For the group as a whole, the average time between primary surgery and a revision was 13.4 months.

Table 1. Revisions and Complications by Implant Volume

200 cc to 349 cc

350 cc to 399 cc

400 cc to 499 cc

500 cc to 599 cc

60 cc to 775 cc

Total, N

Breasts, n

60

97

255

119

42

573

Breasts revised, n (%)

11 (18.3)

6
(6.2)

16
(6.3)

10 (8.4)

4
(9.5)

47
(8.2)

Average follow-up,  month (range)

14.5 (0.5-66)

15.1 (0.3-66)

13.6 (0.5-74)

9.8 (0.3-40)

8.8 (0.5-34)

12.6

Average BMI

20.1

19.8

19.9

20.5

20.8

20.0

Average Satisfaction

4.5

4.7

4.6

4.3

4.6

4.6

Grade 3 palpability

 Smooth

4

6

14

3

0

55

 Textured

2

16

10

0

0


Reference:
Centeno RF, Young VL, Boswell CB. The relationship of breast implant size to complications and satisfaction following primary augmentation mammaplasty: Does size matter? Presented at: Plastic Surgery 2003; San Diego, Calif. October 25-29, 2003: Abstract 3992.

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