Observations on a consecutive series of patients who have had Trilucent breast implants removed as recommended by the MDA Hazard Notice (May 2000).
A prospective study of 25 female cosmetic-surgery patients who had a total of 50 Trilucent breast implants forms the basis of this paper. All but one patient elected to have new implants, of which all but three patients had silicone implants (the others selected glucose saline implants). The Trilucent implants were more difficult to remove than expected because of a 'Velcro-like' attachment to the internal surface of their capsules. As a result, several implants were ruptured on removal (though none were ruptured on initial exposure). The sites of rupture suggest a structural weakness, possibly related to the microchip panel or folds in the implant shell. Varying degrees of encrustation of the implants and internal capsules were found, which did not appear to be related to the duration of implantation. Histological studies of the capsule changes generally showed lipids and giant cell infiltrations. It would seem that, contrary to expectations, leaking of the filler occurs early and is associated with varying degrees of cellular reactions. The adherence problem appears to be related to the amount and distribution of the leaked material. Only three patients in this series had problems with their Trilucent implants that required additional surgery. One of these remains a significant and unsolved problem.
McGregor
J C
JC
Murrayfield BUPA Hospital, Edinburgh, UK.
Brown
D T
DT
D000328:Adult; D001940:Breast / Q000473:pathology; D018427:Breast Implants / Q000009:adverse effects; D020878:Device Removal; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012086:Reoperation; D013997:Time Factors