The Impact of Breast Implant Cohesivity on Rippling and Revision Procedures in 2-Stage Prepectoral Breast Reconstruction
Rippling remains one of the most common complications following prepectoral implant-based reconstruction (IBR). The purpose of this study was to assess how implant cohesivity, a measure of elasticity and form stability, affects the incidence of rippling in prepectoral IBR. We performed a retrospecti...
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Published in | Aesthetic surgery journal. Open forum Vol. 6; p. ojae028 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
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Oxford University Press
04.01.2024
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Abstract | Rippling remains one of the most common complications following prepectoral implant-based reconstruction (IBR).
The purpose of this study was to assess how implant cohesivity, a measure of elasticity and form stability, affects the incidence of rippling in prepectoral IBR.
We performed a retrospective cohort study of 2-stage prepectoral IBR performed between January 2020 and June 2022 at the Brigham and Women's Hospital and Dana-Farber Cancer Institute, comparing outcomes in patients who received Allergan Natrelle least cohesive, moderately cohesive, and most cohesive silicone gel implants. Outcomes of interest were rippling and reoperation for fat grafting.
A total of 129 patients were identified, of whom 52 had the least cohesive implants, 24 had the moderately cohesive implants, and 53 patients had the most cohesive implants. The mean follow-up time was 463 (±220) days. A decreased incidence of rippling was seen with moderately cohesive (odds ratio [OR] 0.30,
< .05) and most cohesive (OR 0.39,
< .05) implants. Third stage reoperation for fat grafting was less frequent in patients with the most cohesive implant (OR 0.07,
< .05). In subgroup analyses, the patients with the most cohesive implant, who did not receive fat grafting at the time of initial implant placement, did not require reoperation for fat grafting (0%).
The use of highly cohesive implants in prepectoral IBR is associated with decreased rippling and fewer reoperations for fat grafting. |
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AbstractList | BackgroundRippling remains one of the most common complications following prepectoral implant-based reconstruction (IBR).ObjectivesThe purpose of this study was to assess how implant cohesivity, a measure of elasticity and form stability, affects the incidence of rippling in prepectoral IBR.MethodsWe performed a retrospective cohort study of 2-stage prepectoral IBR performed between January 2020 and June 2022 at the Brigham and Women's Hospital and Dana-Farber Cancer Institute, comparing outcomes in patients who received Allergan Natrelle least cohesive, moderately cohesive, and most cohesive silicone gel implants. Outcomes of interest were rippling and reoperation for fat grafting.ResultsA total of 129 patients were identified, of whom 52 had the least cohesive implants, 24 had the moderately cohesive implants, and 53 patients had the most cohesive implants. The mean follow-up time was 463 (±220) days. A decreased incidence of rippling was seen with moderately cohesive (odds ratio [OR] 0.30, P < .05) and most cohesive (OR 0.39, P < .05) implants. Third stage reoperation for fat grafting was less frequent in patients with the most cohesive implant (OR 0.07, P < .05). In subgroup analyses, the patients with the most cohesive implant, who did not receive fat grafting at the time of initial implant placement, did not require reoperation for fat grafting (0%).ConclusionsThe use of highly cohesive implants in prepectoral IBR is associated with decreased rippling and fewer reoperations for fat grafting.Level of Evidence 3 Rippling remains one of the most common complications following prepectoral implant-based reconstruction (IBR). The purpose of this study was to assess how implant cohesivity, a measure of elasticity and form stability, affects the incidence of rippling in prepectoral IBR. We performed a retrospective cohort study of 2-stage prepectoral IBR performed between January 2020 and June 2022 at the Brigham and Women's Hospital and Dana-Farber Cancer Institute, comparing outcomes in patients who received Allergan Natrelle least cohesive, moderately cohesive, and most cohesive silicone gel implants. Outcomes of interest were rippling and reoperation for fat grafting. A total of 129 patients were identified, of whom 52 had the least cohesive implants, 24 had the moderately cohesive implants, and 53 patients had the most cohesive implants. The mean follow-up time was 463 (±220) days. A decreased incidence of rippling was seen with moderately cohesive (odds ratio [OR] 0.30, < .05) and most cohesive (OR 0.39, < .05) implants. Third stage reoperation for fat grafting was less frequent in patients with the most cohesive implant (OR 0.07, < .05). In subgroup analyses, the patients with the most cohesive implant, who did not receive fat grafting at the time of initial implant placement, did not require reoperation for fat grafting (0%). The use of highly cohesive implants in prepectoral IBR is associated with decreased rippling and fewer reoperations for fat grafting. Abstract BackgroundRippling remains one of the most common complications following prepectoral implant-based reconstruction (IBR). ObjectivesThe purpose of this study was to assess how implant cohesivity, a measure of elasticity and form stability, affects the incidence of rippling in prepectoral IBR. MethodsWe performed a retrospective cohort study of 2-stage prepectoral IBR performed between January 2020 and June 2022 at the Brigham and Women's Hospital and Dana-Farber Cancer Institute, comparing outcomes in patients who received Allergan Natrelle least cohesive, moderately cohesive, and most cohesive silicone gel implants. Outcomes of interest were rippling and reoperation for fat grafting. ResultsA total of 129 patients were identified, of whom 52 had the least cohesive implants, 24 had the moderately cohesive implants, and 53 patients had the most cohesive implants. The mean follow-up time was 463 (±220) days. A decreased incidence of rippling was seen with moderately cohesive (odds ratio [OR] 0.30, PPP ConclusionsThe use of highly cohesive implants in prepectoral IBR is associated with decreased rippling and fewer reoperations for fat grafting. Level of Evidence: 3 Abstract Background Rippling remains one of the most common complications following prepectoral implant-based reconstruction (IBR). Objectives The purpose of this study was to assess how implant cohesivity, a measure of elasticity and form stability, affects the incidence of rippling in prepectoral IBR. Methods We performed a retrospective cohort study of 2-stage prepectoral IBR performed between January 2020 and June 2022 at the Brigham and Women's Hospital and Dana-Farber Cancer Institute, comparing outcomes in patients who received Allergan Natrelle least cohesive, moderately cohesive, and most cohesive silicone gel implants. Outcomes of interest were rippling and reoperation for fat grafting. Results A total of 129 patients were identified, of whom 52 had the least cohesive implants, 24 had the moderately cohesive implants, and 53 patients had the most cohesive implants. The mean follow-up time was 463 (±220) days. A decreased incidence of rippling was seen with moderately cohesive (odds ratio [OR] 0.30, P < .05) and most cohesive (OR 0.39, P < .05) implants. Third stage reoperation for fat grafting was less frequent in patients with the most cohesive implant (OR 0.07, P < .05). In subgroup analyses, the patients with the most cohesive implant, who did not receive fat grafting at the time of initial implant placement, did not require reoperation for fat grafting (0%). Conclusions The use of highly cohesive implants in prepectoral IBR is associated with decreased rippling and fewer reoperations for fat grafting. Level of Evidence: 3 |
Author | Prospero, Matthew Parikh, Neil Shen, Yizhuo Hyland, Colby J Karinja, Sarah J Starr, Bryce F Reiche, Erik Broyles, Justin M Gadiraju, Goutam K |
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Cites_doi | 10.1097/GOX.0000000000002119 10.1007/s00266-018-1117-y 10.1097/PRS.0000000000006721 10.5999/aps.2019.00353 10.1097/PRS.0000000000000803 10.1097/PRS.0000000000002950 10.1097/PRS.0000000000003627 10.1097/GOX.0000000000003235 10.21037/gs.2018.11.09 10.1016/j.bjps.2006.04.020 10.1097/PRS.0000000000004270 10.33696/pathology.1.008 10.21037/gs.2018.03.05 10.1016/j.ijsu.2014.07.013 10.29252/wjps.8.3.311 10.1097/01.prs.0000176259.66948.e7 10.1097/GOX.0000000000004862 10.1097/GOX.0000000000003060 10.1093/asjof/ojac088 10.1097/PRS.0000000000008013 10.1093/asj/sjy103 |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Dr Reiche is a postdoctoral research fellow, Dr Hyland is a resident, Dr Karinja is chief resident; and Dr Broyles is a plastic surgeon, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. Mr Parikh is a medical student, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA. Presented at: Plastic Surgery The Meeting 2023; October; Austin, TX. Mr Gadiraju, Mr Prospero, Ms Shen, and Mr Starr are medical students, Harvard Medical School, Boston, MA, USA. |
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Snippet | Rippling remains one of the most common complications following prepectoral implant-based reconstruction (IBR).
The purpose of this study was to assess how... Abstract Background Rippling remains one of the most common complications following prepectoral implant-based reconstruction (IBR). Objectives The purpose of... BackgroundRippling remains one of the most common complications following prepectoral implant-based reconstruction (IBR).ObjectivesThe purpose of this study... Abstract BackgroundRippling remains one of the most common complications following prepectoral implant-based reconstruction (IBR). ObjectivesThe purpose of... |
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Title | The Impact of Breast Implant Cohesivity on Rippling and Revision Procedures in 2-Stage Prepectoral Breast Reconstruction |
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