Document Detail


Breast reconstruction and treatment algorithm for patients with complications after polyacrylamide gel injections: a 10-year experience.
MedLine Citation:
PMID:  23381651     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: An algorithm for breast reconstruction for patients with complications after polyacrylamide gel (PAAG) injections is presented, and the outcomes of surgery using the adopted treatment protocol are evaluated.
METHODS: We reviewed the clinical records of consecutive patients who were treated for PAAG complications with breast reconstruction at two surgical centers between 2000 and 2010 (n=154). All patients had one or more complications from PAAG injections and underwent gel removal and breast reconstruction with implants. One hundred women who underwent conventional breast augmentation with implants matching the study cohort comprised a reference group.
RESULTS: Of the total of 154 patients, 121 (79%) women had no signs of acute inflammation and underwent a single-stage surgery comprising gel removal and immediate breast reconstruction (group I). The remaining 33 (21%) patients had signs of acute inflammation (group II) and underwent two-stage surgery with delayed reconstruction. Subgroup analysis of group I revealed that submuscular implant placement was associated with a lower probability of capsular contracture (CC) than was subglandular placement (17 vs. 36%, p<0.05). The rate of CC in patients with textured implants (n=81) was 24.8%, whereas no CC was registered among patients with micropolyurethane surface implants (n=40). The rate of early surgical complications in group I, group II, and the reference group was 39, 51.5, and 9%, respectively. The probability of reoperation after breast reconstruction in group I and in group II was 34 and 42%, respectively.
CONCLUSION: Complications and subsequent breast reconstruction in patients after PAAG injection pose a challenge to the surgeon; however, satisfactory results can be achieved in the majority of patients. The reconstruction algorithm described here may serve as a useful tool for breast surgeons dealing with PAAG complications.
LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Authors:
Gennadiy Patlazhan; Dmytro Unukovych; Kirill Pshenisnov
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study     Date:  2013-02-05
Journal Detail:
Title:  Aesthetic plastic surgery     Volume:  37     ISSN:  1432-5241     ISO Abbreviation:  Aesthetic Plast Surg     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-26     Completed Date:  2013-09-19     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  7701756     Medline TA:  Aesthetic Plast Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  312-20     Citation Subset:  IM    
Affiliation:
Ukrainian Institute of Plastic Surgery Virtus, Bunina str. 10, Odessa, 65026, Ukraine.
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MeSH Terms
Descriptor/Qualifier:
Acrylic Resins / adverse effects*,  pharmacology
Adolescent
Adult
Algorithms*
Breast Implants / adverse effects*
Cohort Studies
Female
Follow-Up Studies
Humans
Injections / adverse effects
Mammaplasty / adverse effects,  methods*
Middle Aged
Postoperative Complications / physiopathology,  surgery
Prosthesis Failure*
Reoperation
Retrospective Studies
Time Factors
Ukraine
Young Adult
Chemical
Reg. No./Substance:
0/Acrylic Resins; 9003-05-8/polyacrylamide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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