[Critical results 6 years later]

[Mamma-Augmentation mit Silastic-Prothesen.]

Fortschr Med 1982 Apr 8;100(13):600-4

(ISSN: 0015-8178)

Brobmann GF; Gospos C

68 patients have undergone augmentation mammaplasties in the last 6 years in our Dept. of Surgery. 15 reoperations (capsulotomy, capsulectomy, change of the implant) had been necessary. We observed unfavorable results causing patient dissatisfaction in 22%, mostly due to capsular contracture. It should be mentioned that satisfaction was much greater in the group of unilateral hypoplasia (10 cases). Reoperation have not been necessary in this group. The range of indications for augmentation mammaplasties should be limited.

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(ISSN: 0032-1052)

Baker JL; Le Vier RR; Spielvogel DE

A specific quantitative assay was developed to determine silicone concentrations in contracted mammary capsular tissue. The concentrations of silicone in tissues from 14 patients with gel filled implants varied from 15 to 9800 micrograms polydimethylsiloxane per gram of tissue. This silicone is probably a high-molecular-weight polymer that has diffused through the implant envelope. Samples from a patient with saline-filled implants contained no silicone. The concentration of silicone was not related to capsule age. The polymer in these tissues appeared to be unaltered, in that no evidence of metabolic products was found.

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Plast Reconstr Surg 1982 Feb;69(2):337-9 (ISSN: 0032-1052)

Christ JE; Askew JB

Injectable silicones have been applied to an undetermined number of men for penile augmentation. The practitioners of this art, whether lay or medical, have allegedly long discontinued treating penile size. In the literature to date, four men have been identified as having complications from this mode of therapy; three have had excisions of granulomatous masses secondary to the silicone; the third refused surgery. This paper reports an additional case of silicone granuloma of the penis, documented by biopsy, which necessitated two excisions to obtain a satisfactory size for copulation. Moreover, because of impotence, a Dow-Corning (Gerow design) penile prosthesis was inserted. The inflammatory response in this new case is identical to that found in other parts of the body, namely, multiple silicone droplets surrounded by multinucleated giant cells and chronic inflammatory cells.

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J Urol (Paris) 1982;88(6):337-43

(ISSN: 0248-0018)

Genest H; Guidoin R; Plante R; Gosselin C; Blais P; Robert G;

Laroche B; Marois M; Clavel F; King M

Two juvenile size silicone testicular prostheses were analyzed following replacement by adult size devices after 72 and 99 months in situ. Scanning electron microscopy and electron microprobe studies were carried out on the explanted silicone prostheses and their attached tissue capsules. The material at the surface of the prostheses gave no evidence of biodeterioration. However, localized sites of calcification were observed. The adjacent tissue capsule consisted of two distinct concentric layers with different morphologies; the one adjacent to the prosthesis consisted of dense arrays of collagen fibres oriented parallel to the silicone surface and extending outward to a thickness of 100-120 microns. The outer layer was less dense, more disordered and was uneven in thickness. It contained numerous discrete particles of silicon-rich material. Technical and clinical implications of these results are discussed.

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Arch Dermatol 1981 Jun;117(6):366-7 (ISSN: 0003-987X)

Mason J; Apisarnthanarax P A 38-year-old woman had a migratory silicone granuloma of the left upper portion of the chest and left upper arm secondary to a ruptured breast implant. The initial diagnosis was factitial panniculitis. With the common use of silicone in cosmetic surgery, physicians should inquire into a possible history of silicone injections or implants before ascribing a factitial cause to foreign-body granulomas.