title: Sonographic criteria for the confirmation of implant rotation and the development of an implant-capsule-interaction ("interface") in anatomically formed textured breast implants with texturised Biocell-surface.
abstract: OBJECTIVE
  In comparison to round breast implants, anatomically formed implants have a broader indication spectrum in augmentation surgery for the formation of a natural breast shape. In order to achieve a long-term result, it is necessary for anatomically formed breast implants to remain secured in the position desired and planned initially. In the case of textured implants of a certain pore size and depth, this can be aided by the development of a stabilising implant-capsule-interaction (interface). The aim of this study was to investigate whether there are sonographic criteria for verifying the position of anatomically formed breast implants and the development of a stable interface.
  
  
  METHODS
  628 patients underwent breast implant surgery and were followed up clinically as well as sonographically at the Frauenklinik und Institut für Asthetische Chirugie am St. Josefs-Hospital, Wiesbaden. 228 implants (Style 410 Inamed McGhain) were evaluated after a mean of 27 months postoperatively. Only cosmetic augmentations were included in the results. Verification of the implant position was conducted by palpation as well as by sonography. Statistical analysis was performed using the McNemar-Test (Chi-squared test).
  
  
  RESULTS
  Two marker points on the anterior side of the implant capsule in the lower hemisphere, which are designed for intraoperative position monitoring by palpation, could be reproduced sonographically in all cases and the position of the breast implant could thereby by determined. Two cases of clinically apparent implant rotation of more than 90 degrees around the vertical axis were discovered in this way. The sonographical identification of the development of a stable interface between the implant and the periprosthetic capsule is possible when sonographic criteria of the "parasternal movement layer" are met. The sonographic outcome is significantly superior to palpation.
  
  
  CONCLUSIONS
  Breast sonography used for the clinical follow-up of patients with anatomically formed breast implants represents an efficient diagnostic supplement with clinical relevance.
authors.affiliation: Universitäts-Frauenklinik, Tübingen. markus.hahn@med.uni-tuebingen.de
authors.forename: M
authors.initials: M
authors.lastname: Hahn
authors.forename: R P
authors.initials: RP
authors.lastname: Kuner
authors.forename: P
authors.initials: P
authors.lastname: Scheler
authors.forename: K
authors.initials: K
authors.lastname: Freidel
authors.forename: G
authors.initials: G
authors.lastname: Hoffmann
authors.forename: H
authors.initials: H
authors.lastname: Madjar
authors.forename: D
authors.initials: D
authors.lastname: Wallwiener
authors.forename: U
authors.initials: U
authors.lastname: Krainick-Strobel
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D018427:Breast Implants; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000473:pathology; D003238:Connective Tissue / Q000000981:diagnostic imaging; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D005549:Foreign-Body Reaction / Q000000981:diagnostic imaging; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000473:pathology; D011474:Prosthesis Design; D011475:Prosthesis Failure; D017755:Prosthesis Fitting; D013499:Surface Properties; D016217:Ultrasonography, Mammary