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The Association Between Silicone Leakage And Capsular Contracture In 431 Patients With Intact Silicone Breast Implants
Andreas Larsen, MD1, Erik E. Bak, BMsc
1, Tim K. Weltz, MD
1, Mathilde N. Hemmingsen, MD
1, Jens Jørgen Elberg, MD
2, Jesper Trillingsgaard, MD
3, Lisbet R. Hölmich, MD, DMSc
4, Tine E. Damsgaard, MD, PhD, MRBS
5, Peter Vester-Glowinski, MD, PhD
1, Mathias Ørholt, MD
1, Mikkel Herly, MD, PhD
1;
1Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark,
2Amalieklinikken, Copenhagen, Denmark,
3AK Nygart, Copenhagen, Denmark,
4Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark,
5Odense University Hospital, Odense and Little Belt Hospital, Vejle, Denmark
PURPOSE: To determine if silicone leakage from intact breast implants to the breast implant capsule is associated with capsular contracture.
METHODS: We studied excision biopsies from patients undergoing removal or exchange of intact silicone breast implants. Patients with previous implant exchange were excluded. The silicone deposit in the implant capsule was quantified by histological analysis. The association between silicone content in the implant capsule and capsular contracture was tested using ordinary least squares regression and a paired analysis.
RESULTS: We included 431 patients with 690 breasts. The preoperative Baker grade examination categorized 377 breasts (55%) as Baker I, 154 breasts (22%) Baker II, 87 breasts (13%) Baker III, and 72 breasts (10%) Baker IV. Silicone leakage from intact implants was associated with increased risk of capsular contracture independently from the time of implantation (
p<0.01). A stratified analysis showed that the association was only significant within the first 10 years of implantation (
p<0.01) and not significant after 10 to 20 years (
p=0.11) or above 20 years (
p=0.56). The correlation between silicone leakage and capsular contracture was confirmed in a paired subgroup analysis of 51 patients with one breast with capsular contracture and a contralateral healthy breast.
CONCLUSION: Our findings suggest that silicone leakage from intact breast implants plays a role in the development of capsular contracture particularly in the first 10 years of implantation.
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