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Long-term Aesthetic Outcomes, Complications And Patient Satisfaction With Silicone Cohesive-gel Implants, A Ten Year Experience.
Claudia R. Albornoz, MD, Peter G. Cordeiro, MD, Qunying Hu, MD, Amie MD Scott, MPH.
Memorial Sloan Kettering Cancer Center, New York, NY, USA.

PURPOSE:
Silicone-cohesive gel implants were recently approved by the FDA for general use; however, their safety and effectiveness is still under scrutiny. The objective of the current study was to compare long-term aesthetic outcomes, complications, and patient satisfaction of cohesive-gel implants with silicone non-cohesive and saline devices.
METHODS:
Prospectively collected information from patients with implant breast reconstruction (2000-2010) was queried. Patient and treatment information, complications, surgeon-assessed aesthetic outcomes and adjusted patient-reported satisfaction with breasts (BREAST-Q scores) were compared by implant type (silicone-cohesive gel, silicone non- cohesive and saline).
RESULTS:
Information from 1,432 patients with 877 silicone-cohesive implants, 333 non-cohesive and 931 saline devices was included. Silicone-cohesive implants were 70% more likely to have an excellent aesthetic result (p<0.01), 86% less likely to leak (p=0.01) and 92% less likely to ripple compared to saline implants (p<0.01). Adjusted satisfaction with breasts scores were similar between silicone cohesive and saline implants (62.2 vs. 62.3), with differences in visible and palpable ripping (p<0.01). Silicone non-cohesive implants were more likely to have an excellent aesthetic result than saline implants (p<0.01) with no difference in satisfaction with breasts scores other than visible rippling (p<0.01)
CONCLUSION:
Although silicone-cohesive gel implants have better surgeon-evaluated aesthetic results, less rippling and less leakage when compared to saline implants, patient-reported satisfaction with breasts is similar with exception of visual and palpable rippling. The difference between silicone-cohesive gel and non-cohesive implants is only surgeon-evaluated aesthetic results with no difference in satisfaction with breasts other than visible rippling.


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