Outcomes of In-Office, High Resolution, Ultrasound Silicone Breast Implant Surveillance by Plastic Surgeons.

Autor:	Glener AD; Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA., Sergesketter AR; Division of Plastic Surgery, Duke University Medical Center; Durham, NC, USA., Adams WP Jr; Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Jazyk:	angličtina
Zdroj:	Aesthetic surgery journal [Aesthet Surg J] 2024 Jul 26. Date of Electronic Publication: 2024 Jul 26.
DOI:	10.1093/asj/sjae165
Abstrakt:	Background: Implant rupture is a known complication in cosmetic breast surgery but access and cost barriers hinder proper implant surveillance. Objectives: This study aims to validate High Resolution Ultrasound (HRUS) for diagnosing silicone implant rupture, and secondarily, explore the predictors of implant rupture in a single-surgeon cohort. Methods: A retrospective chart review identified patients who underwent HRUS of silicone breast implants that were placed by the senior author (WPA). HRUS sensitivity/specificity and predictive values were calculated. Multivariable logistic regression assessed predictors of implant rupture. Kaplan-Meier methods estimated 10 and 15-year implant survival. Results: Among 254 patients (508 implants) included, 52 patients (104 implants) underwent operative exploration for various reasons; 20 implants had confirmed ruptures. Examining this operative cohort, HRUS had excellent positive and negative predictive value, respectively, 100% (95% CI 83.1-100%) and 97.6% (95% CI 91.6-99.3%); the sensitivity was 90.9% (95% CI 70.8-98.9%) and specificity was 100% (95% CI 95.6%-100%). The median age of the implant at the time of ultrasound was 119 months (10 years; IQR 79-152 months). After multivariable adjustment, the only the implant age was a significant predictor of implant rupture (p=0.04). Across the entire cohort, Kaplan-Meier methods estimated a 10-year and 15-year implant survival rate of 0.98 (95% CI 0.96-0.99) and 0.80 (95% CI 0.71-0.87), respectively. Subgroup analysis showed 10 and 15-year implant survival rates of 0.99 and 0.92, respectively, for surveillance-only HRUS patients. Conclusions: Plastic surgeon delivered office-based HRUS surveillance is a highly sensitive and specific method to assess silicone breast implant integrity. (© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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