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Four weeks optimal for gland normalization after saline implant deflation in revisional breast surgery

Researchers found that a 4-week period is optimal for “elastic breast recoil” prior to secondary breast surgery.

The retrospective chart review included 55 patients who underwent saline implant deflation 4 weeks before 57 revisional surgeries. Seventeen revisions did not use implants and 40 had revision with implants.

Eight out of 55 women had capsular contracture and of those, four had Baker IV capsular contracture.

Of the 17 cases without the use of implants: one had removal only, nine with concurrent mastopexy, two with fat grafting, two with mastopexy and fat grafting and three with additional reduction, mastopexy and fat grafting.

Researchers found no deflation-related complications and no infections from deflated saline in the capsule, along with no psychological sequelae from the period of deflation and no failures to proceed with revisional surgery.

A subset of 10 patients received 3-D imaging at the initial consult (Time 1), immediately after deflation (Time 2) and 3 weeks after deflation (Time 3).

The volume differences between the initial consult and immediately postdeflation were recorded for each breast and then compared to the actual deflation volume and the patient-reported volume of their saline implants.

Patients had an average 15.45% increase in volume and a decrease of 0.18 cm in the sternal notch-to-nipple distance.

In practice, the researchers offer deflation for patients with saline implants before the size change to smaller implants.

This helps to include the patient in the decision making of their procedure and helps them visualize their own breast tissue that they have to start with. – by Abigail Sutton

Disclosure: Grotting is a shareholder in the Aesthetic Surgeons Financial Group (Birmingham, AL) which owns CosmetAssure (Montgomery, AL). He also receives book royalties from Quality Medical Publishing (St Louis, MO) and is a shareholder in Keller Medical, Inc. (Stuart, FL) and Ideal Implant, Inc. (Dallas, TX).