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Breast volume increases post saline deflation at 3 weeks prior to revision

“Elastic breast recoil” after saline implant deflation is important to consider prior to revision surgery and is likely caused by a shortening of the suspensory ligaments and recovery of parenchyma that were stretched from the implant, leading to re-expansion of the gland.

The retrospective 12-year chart review included 55 patients who underwent 57 revisional aesthetic breast surgeries with preoperative saline implant deflation and reports of normal preoperative mammography reports.

A cohort of 10 patients had preoperative 3-D imaging at initial consult, immediately after deflation and 3 weeks after deflation.

If patients were satisfied with the volume at 1 week prior to surgery she was offered: (1) removal of the deflated saline implant alone; or (2) removal of deflated saline implant and mastopexy with or without fat grafting. If she wished to be larger, the options were: (1) removal and replacement with implant and mastopexy with or without fat grafting; or (2) removal and replacement with or without fat grafting.

Seventeen procedures were performed without implants. Forty procedures required an additional implant: 13 had replacement with an implant only, 19 had removal, replacement and mastopexy; three had removal, replacement, mastopexy and fat grafting; four had addition, subtraction and mastopexy; and one had addition, subtraction, mastopexy and fat grafting.

No deflation-related complications were reported, including no infections from deflated saline in the capsule, no psychological sequelae from the deflation period and no failures to proceed with revisional surgery.

Patients in the 3-D imaging cohort showed an average increase of 15.45% in volume as well as a decrease in the sternal notch-to-nipple distance of 0.18 cm over an average deflation of 31.5 days.

Accurately assessing parenchymal volume is necessary to determine a patient’s specific volume needs, according to researchers.

The researchers have found elastic breast recoil in patients with both silicone explantation or saline deflation and suggested waiting until this recoil has occurred to clarify preoperative revisional planning. – by Abigail Sutton

Disclosure: Wu reported no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.