Inflatable breast implants, which have been available for 27 years, have been accepted with varying enthusiasm. Advocates suggest that they result in breasts that look and feel natural because they have a low incidence of capsular contracture. Others note the obvious: Anything that is inflated may deflate. The purposes of this report are to present our experience with inflatable breast implants and to focus on deflation.
We examined the records of all our patients who underwent breast augmentation or reconstruction. The 173 patients who had 326 inflatable breast implants form the basis of this report. Eighty-four percent of the patients were treated for aesthetic reasons; 16 percent were for reconstruction after mastectomy. The longest follow-up was 14.5 years, and the shortest was 3 months.
Our findings indicate that inflatable breast implants remain soft. Overall, 256 implants (78.5 percent) were Baker I, 39 (12.0 percent) were Baker II, 28 (8.6 percent) were Baker III, and 3 (0.9 percent) were Baker IV. Twenty (6.1 percent) of the 326 implants deflated. No patient whose implant deflated had a closed capsulotomy nor gave a history of a proximate athletic endeavor. Most deflations were associated with pain, not previously present, and over the next few days the patient noted that her breast became smaller. All deflations were explored surgically, usually within 1 week. At surgery, a white fold was noted usually where the leak in the implant occurred. It was easy to slide out the old implant and insert a new one.
The shortest interval between the surgery and deflation was 3 months; the longest was 9 years and 9 months. Kaplan-Meier product limit survival analysis was performed. The cumulative percentage implant survival at 117 months was 67.3 percent; median survival was not reached over the period of this study.
In conclusion, we believe that inflatable implants result in soft breasts (90 percent were Baker I or II) and that the deflation rate (6.1 percent) is acceptable. However, with the passage of time, the cumulative number of deflations increases. Should deflation occur, the patient is inconvenienced, but no dangerous medical problem occurs. (Plast. Reconstr. Surg. 93: 118, 1994.)