Evaluation of Different Breast Implants for Rupture and Durability after Implantation
Authors: ÖRS Safvet 
Published: December 2022

Aim:
This study includes the evaluation of 84 implants removed after an average of 10 years from 42 patients who underwent augmentation mammoplasty and augmentation mastopexy at various centers over a 20-year period.

Patients and Methods:
Implants from patients who were all women aged between 28-60 years were evaluated after an average of 10 years following breast implantation. Preoperative physical examination, ultrasound examination and magnetic resonance imaging (MRI) were performed. Breast implants were removed from 42 patients for various reasons. The capsules and the free fluid removed with the implants underwent pathological and cytological evaluation. 84 implants that were removed were evaluated and scored for rupture, gel leakage, presence of air in the gel, changes in shell structure, and base deformities. Implants without any deformity were given a full score of 10, while score reduction was made according to various types of deformities seen in other implants. The average score of each implant brand was compared to other brands.

Results:
Rupture was observed in 23 of a total of 84 implants, while implant deformities such as gel leakage, air presence in the gel, decreased elasticity, base deformity and thinning of the shell were also present. Among all, 16 implants received a full score. The durability of the implants in the human body and the damage they received were classified according to their scores. Those with a score of eight and above were classified as high, those with a score between 6-8 were classified as medium, and those with a score of less than six were classified as implants with low endurance. Most of the implants evaluated here had low to medium endurance. The volume of one of the ruptured implants was 200 mL, while the rest ranged from 275-400 mL. Bilateral rupture was observed in one patient with a McGhanR implant, which had stayed in the human body the longest (15 years). Apart from this, all ruptures in other cases were unilateral. In some of the implants of EurosiliconeR(three implants), McGhanR(two implants), NatrellaR(one implant), RofilR(one implant) and PolytechR(one implant), it was observed that the implant shell was completely torn, fragmented and disintegrated, and the gel was diffused into the capsule. Shell decay was much higher especially in EurosiliconeR, RofilR and McGhanR brands. The durability of the implants was classified according to their scores. High endurance implants were those with a score of eight and higher: MentorR, SilimedR, MotivaR, and ArionR. Medium endurance implants were those with a score between 6-8: EurosiliconeR, PolytechR, McGhanR, and NatrellaR. Low endurance implants were those with a score of six and lower: RofilR and PipR. Conclusions: Occurrence of rupture and various complications increase in implants especially after 10 years. Often from certain brands, particularly the high-volume implants, rupture more easily in time. Close follow-up should be planned for patients who have had implants for more than 10 years, considering the duration, implant brand and volume.