Die Zeit ist reif für ein deutschlandweit verpflichtendes Brustimplantateregister – Pilotprojekt Brustimplantate Erhebungsbogen

Background: Scandals concerning breast implants confuse patients, medical doctors and the public. Till now legally binding consequences are missing despite repeated requests. The aim of this study was to establish and implement a breast implant template for our clinic to increase the patient's safety and the assessment of implants in course of time. Patients and Methods: In January 2013 our clinic started a pilot project with a self-developed digital breast implant template. This digital template is filled out by the surgeon after each breast implant operation. Furthermore, we retrospectively evaluated the data of all patients that underwent breast implant surgery in our clinic since 2000. Till the end of December 2015 we created 408 breast implant forms. The time spent for processing this template and reasons for implantation, explantation or revision have been collected. Results: 247 primary augmentations and 161 revisions of breast implants had been performed (n = 408 breast implant forms). Main reason for explantation or revision was capsular fibrosis (n = 304). The time spent for processing this template for primary implantation was 01: 57 min (MW: 01: 57 +/- 00: 49) and for implant revision 02: 13 min (MW: 02: 13 +/- 00: 38). Conclusion: The breast implant template optimized the quality of our treatment, revealed possible complications quickly, allowed a valuable tracing of the breast implants and improved the consultation of our patients with regards to different devices and therapies

Semiquantitative measurements of capsular contracture with elastography - First results in correlation to Baker Score

BACKGROUND: To estimate the presence and severity of capsular contracture in patients after breast implants an objective measurement tool is necessary. PATIENTS AND METHODS: Eleven patients (range of age 37 to 53 years) who underwent cosmetic breast augmentation (seven patients with bilateral implants) or breast reconstruction by mammary asymmetry (four patients unilateral) with smooth silicone gel implants were included in this prospective study. In total seventeen implants were examined clinically and with the colour coded Ultrasound Elastography using a multifrequency probe (5-10MHz Siemens Antares Premium VFX13-5). The grade of capsular contracture was assessed by two examiners with the palpation method and classified according to the Baker score. The Ultrasound Elastography was performed by two radiologists specialized in breast imaging and was correlated with the Baker score, colour coded ultrasound elastography and a high resolution ultrasound B-scan score (0-5). RESULTS: The clinical examination proved following distribution of the Baker degree: 6 breast implants with Baker grade I and Baker grade II, 3 breast implants with Baker grade III and two breast implants with Baker grade IV. There was a high correlation between the Baker score and the objective scoring measured by Ultrasound Elastography (kappa 0.83-0.89). CONCLUSION: The new technology of Ultrasound Elastography represents a useful tool to evaluate the compressibility of the peri-implant capsule, the implant and the surrounding tissue