Diagnostic value of spectral CT imaging on complications after breast augmentations with siliconeim plants / 中华医学美学美容杂志

Objective To evaluate the diagnostic value of the spectral CT imaging on the complications after breast augmentations with silicone implants.Methods A lot of 22 cases with breast implants were scanned by the Gemstone spectral imaging (GSI) CT.The original data were loaded in processed workstation, analyzed by GSI analysis software, and then stored the series we needed.The features of the complications after breast augmentations with silicone implants were reviewed retrospectively on the spectral CT images.Results A lot of 44 breast implants scanned in our study and there were 23 breast implants with complications, including 7 breast implants with capsular rupture (6 breast implants with endometrial rupture detected by spectral CT, including 4 breast implants with endometrial rupture, 3 breast implants with outer membrane rupture and leakage), 13 breast implants with capsular contracture (classification according to Baker's classification, 6 in grade Ⅰand 7 in grade Ⅱ), 8 breast implants were moved and 2 breasts had foci of calcification.Conclusions The spectral CT imaging play important role in detecting the complications after breast augmentations with silicone implants by GSI analysis software.

Mastoplastia redutora associada a implante de silicone: quando indico? / Reduction mastoplasty with silicone implants: When is it indicated?

Introdução: Insatisfação dos pacientes com resultado de mamoplastia redutora pode ser identificado em alguns casos, especialmente quando apresentam ptose acompanhada de flacidez excessive, estrias, e ainda, componente mamário mais gorduroso que glandular. Nesses tipos de pacientes, é muito difícil conseguir bons resultados por longo período. Implantes mamários de pequeno volume, podem ser colocados no mesmo tempo da mamoplastia redutora com o objetivo de se obter melhor forma, contorno e projeção das mamas, com maior satisfação a longo prazo. Método: No período de 1997 a 2012, duzentos e sessenta e quatro pacientes com idade entre 27e 55 anos (idade média de 38), foram submetidas à mamoplastia redutora com imediata colocação de implante mamário. Resultados: Foram obtidos resultados satisfatórios, com adequado preenchimento do pólo superior, mamas firmes e reduzida estatística de ptose pós-operatória. Foram identificados dois casos de carcinoma in sito, como achados no anátomo-patológico. Conclusão: Mastoplastia redutora associada a implantes de silicone é um procedimento seguro para casos selecionados.

INTRODUCTION: Patient dissatisfaction with reduction mammoplasty outcomes can occur, especially in cases of ptosis accompanied by excessive flaccidity, striations, and a higher fat than glandular content. In such cases, achieving long-lasting results is very difficult. Small-volume breast implants can be placed during the reduction mammoplasty with the purpose of obtaining better breast shape, contour, and projection as well as greater long-term satisfaction. METHOD: Between 1997 and 2012, 264 patients aged 27-55 years (mean, 38) underwent reduction mammoplasty with immediate placement of breast implants. RESULTS: Satisfactory results were obtained, with adequate filling of the upper pole, increased breast firmness, and statistical reduction in postoperative ptosis. Two cases of carcinoma in situ were identified in the pathological exam. CONCLUSION: Reduction mastoplasty associated with silicone implants is safe for selected cases.

Calcification Deposits in Nasal Silicone Implants: Regional Distribution in Relation to Surrounding Soft Tissues

Because medical grade silicone rubber implants are highly biocompatible, easily formable and inexpensive polymers, they are commonly used in augmentation rhinoplasty, augmentation mentoplasty and augmentation mammoplasty. Although silicone is believed to be biologically inert for a long time in the body, it can elicit calcification on the surface of the implants as it is known from experience with breast and orbital implants. However, there has been no report on calcification deposits on the surface of nasal silicone implants. Calcification on such implants was discovered during revisional rhinoplasty and the relationship between the calcified surfaces of the implants and the soft tissues surrounding the implants was studied. Nineteen implants were studied from female patients, at times ranging from 12 to 35 years after dorsal silicone implantation. To determine the rhinion's position relative to the implant, the length from the cephalic end of the implants(the 'golden point') to the rhinion was measured on 27 soft tissue profile cephalometric radiographs from the patients who had received dorsal silicone implantation in the past. This showed that the rhinion was situated at a point 42.22% along the length of the implants from the golden point. The surface of the implants was divided into four zones not only by the rhinion but also in relation to the quality of the soft tissues surrounding the implants. Zone I was the cephalic portion of the dorsal surface of the implant in contact with the periosteum. Zone II was the caudal portion of the dorsal surface in contact with the musculoaponeurotic layer. Zone III was the cephalic portion of the ventral surface in contact with the nasal bone. Zone IV was the caudal portion of the ventral surface in contact with the perichondrium. The 19 removed implants were wrapped with transparent tracing paper. The outlines of the implants and calcification areas were drawn and photographed. After placing on images of the photographs, using Adobe Photoshop version 7.0, the areas of calcification were measured. The relative area of calcification was 48.37% in zone I, 36.61% in zone II, 19.17% in zone III, and 14.33% in zone IV respectively. The calcification area of zone I was significantly greater than in other zones(zone II p<0.041; zone III p<0.002; and zone IV p<0.001) and that of zone II was greater than zone III(p<0.002) and IV(p<0.001). The relatively high degree of calcification of zone I was possibly caused by the osteogenic effect of osteoprogenitor cells in the richly vascularized periosteum. Because zone II is more mobile than the cephalic portion of the nose, increased calcification here might have been resulted from mechanical abrasion caused by movement of the muscle layer.