Original Article
Complications Leading to Surgery after Breast Implantation
N Engl J Med 1997; 336:677-682March 6, 1997
- Abstract
Background
Local complications that require additional surgical procedures are an important problem for women with breast implants.
Methods
We studied 749 women who lived in Olmsted County, Minnesota, and received a first breast implant at the Mayo Clinic between 1964 and 1991. We identified complications that occurred after the initial procedure and after any subsequent implantation. A complication was defined as a surgical procedure performed for any of the following reasons: capsular contracture; rupture of the implant; hematoma or bleeding; infection or seroma of the wound; chronic pain; extrusion, leakage, or sweating of the implant; necrosis of the nipple, areola, or flap; malfunction of the filler port of a tissue expander; and wound dehiscence.
Results
During follow-up (mean, 7.8 years; range, 0 to 25.8), 208 (27.8 percent) of the women underwent 450 additional implant-related surgical procedures. Ninety-one (20.2 percent) were anticipated, staged procedures or were done because the patient requested a size change or aesthetic improvement, and 359 procedures (79.8 percent) had at least one clinical indication (thus constituting a complication). Complications occurred in 178 (23.8 percent) of the 749 women and involved 274 (18.8 percent) of the 1454 breasts with implants and 321 (18.8 percent) of the 1703 implants. The most frequent problem was capsular contraction (131 women), followed by implant rupture (43 [5.7 percent]), hematoma (43), and wound infection (19). The rate of complications was significantly lower (P<0.001) among women with cosmetic implants (6.5 percent at one year, 12 percent at five years) than among those who received implants after mastectomy for breast cancer (21.8 percent at one year, 34 percent at five years) or prophylactic mastectomy (17.3 percent at one year, 30.4 percent at five years).
Conclusions
Women who have had breast implantation frequently experience local complications during the subsequent five years. Complications were significantly less frequent among patients who received implants for cosmetic reasons than among those who received implants after mastectomy for cancer or for cancer prophylaxis.
Media in This Article
Figure 2
Cumulative Risk of Complications (Kaplan–Meier Estimate) among Women Who Underwent Breast Implantation for Cosmetic Reasons, According to the Date of Implantation.Figure 3
Survival (Kaplan–Meier Estimate) among Women Who Received Breast Implants, According to the Reason for the Implantation.Article Activity
- Article
In the United States, 1 million to 2 million women have undergone breast implantation.1,2 We previously reported the results of a retrospective cohort study that showed no increased risk of connective-tissue or autoimmune disorders among women with breast implants as compared with women without implants.3 Even among investigators who are unimpressed with the risk of systemic side effects associated with breast implants, there is concern that local complications may be an important problem.4-7 However, no population-based data on this subject are available. Consequently, we undertook this analysis to describe the occurrence of surgically treated local complications in the population-based cohort of women residing in Olmsted County, Minnesota, who received their first breast implant at the Mayo Clinic between January 1, 1964, and December 31, 1991.
Methods
Collection of Data
The methods of case ascertainment and the procedures for follow-up have been described in detail elsewhere.8 The study was approved by the institutional review board of the Mayo Clinic and Foundation. In this study, as in most Rochester Epidemiology Project studies,9 a large number of potential cases were screened through a review of medical records in order to ensure that information about each case was complete, eliminate duplicates, and certify that all the included cases fulfilled explicit residency, temporal, diagnostic, and surgical criteria.
We obtained a list of 971 identifying numbers of purported Olmsted County residents who had undergone breast implantation, breast augmentation, or breast reconstruction. A review of the complete (inpatient and outpatient) community medical records of all of these cases showed that there were 19 duplicates (cases in which two identifying numbers had been assigned to the same person). Of the remaining 952 cases, 127 were excluded for the following reasons: 55 patients had had breast operations that did not involve implants (such as breast reduction), 50 had been incorrectly classified as residents of Olmsted County, 11 were residents of Olmsted County who had undergone their first breast implantation elsewhere, 6 cases represented transcription errors, 3 cases involved lost or unavailable medical records, and 2 patients were men who had received implants (for example, for congenital absence of the pectoralis muscle).
Data collection was completed for the remaining 825 women. Of these women, 76 were residents of one of the six counties adjacent to Olmsted County. These patients were excluded from the final cohort in order to maintain the integrity of the population-based study design, even though other analyses including them (which were presented in a preliminary report10) led to conclusions similar in every respect to those of the analyses of the Olmsted County case cohort. The final sample size was, therefore, 749. This cohort was subdivided according to the reason for implantation: cosmetic, cancer (reconstruction after mastectomy for breast cancer), or prophylactic (reconstruction after subcutaneous mastectomy for cancer prophylaxis among women at high risk for breast cancer).
One of four trained nurse–abstractors reviewed each woman's entire medical record (including all inpatient and outpatient reports from the local providers of medical care), and information was obtained on the occurrence of and the indications for any of various implant-related surgical procedures. These procedures were removal of the implant, replacement of the implant, open capsulotomy (incision of the fibrous capsule surrounding the implant), capsulectomy (removal of the fibrous capsule), incision and drainage of a wound abscess, evacuation of a hematoma, wound repair, excision or grafting of the skin because of necrosis, and adjustment of the filler port of a tissue expander. A tissue expander is a balloon-type prosthesis that is typically placed under the pectoral muscle and expanded gradually (usually over the course of several weeks) by means of a tube that leads to a filler port through which saline is injected transcutaneously. The prosthesis is commonly expanded to a size considerably larger than that ultimately desired. It is allowed to remain overexpanded for several months, after which saline is withdrawn through the port to reduce the prosthesis to the desired size, thus yielding a soft, naturally contoured breast. After sizing is complete, a small incision is made and the subcutaneously positioned filler port is withdrawn through a self-sealing valve with the patient under local anesthesia.
Implant removal was categorized as temporary if the implanted device was removed to facilitate another procedure (such as drainage of a hematoma) and then reinserted (either during the second procedure or at a later time) and as permanent if the device was removed and not reinserted. The scheduled replacement of a temporary tissue expander with a permanent implant was considered a procedure but not an implant removal. All indications for each procedure were recorded. Clinical indications included capsular contracture or formation; rupture of the implant; hematoma or bleeding; infection or seroma of the wound; extrusion, leakage, or sweating of the implant; chronic pain; necrosis of the nipple, areola, or flap; filler-port malfunction; and wound dehiscence. Other indications included the request of the patient, replacement of a temporary device, replacement of the implant with a more modern device, and replacement of the implant due to the age of the device. A complication was considered to have occurred if there was at least one clinical indication for a surgical procedure.
Follow-up for each of the women continued from the time of the first implantation procedure until migration from Olmsted County, death, or the end of study follow-up (1993). Vital status at the time of the last follow-up contact was also recorded for each patient.
Data were recorded on a pretested data-collection form, entered into a computer, and edited with various on-line checks for range and consistency. To ensure that the data regarding implant-related surgical procedures were of high quality, 50 sets of medical records were reviewed a second time by one of us. In consultation with surgical colleagues and the other co-investigators, we developed explicit definitions for surgical procedures and their indications. A data-collection instrument that incorporated these definitions was designed and pretested. Using this instrument, we re-abstracted the medical records of all patients originally identified as having had an implant-related surgical procedure.3
Statistical Analysis
The Kaplan–Meier product-limit method was used to estimate the probabilities of overall survival and of survival free of complications as functions of the length of time since implantation for subgroups defined according to the reason for implantation and other factors. A generalization of the Cox proportional-hazards model, developed to analyze correlated survival data,11-13 was used to examine the effects of several variables (age, the date of implantation, the number of previous implants, the number of previous complications, and the reason for the implant) on the time until the first complication after each implantation. The end points were correlated, because most women had bilateral implants and some had multiple implants in the same breast. In these analyses, follow-up of each breast implant continued until a complication occurred, the implant was removed, or the date of the last follow-up contact was reached.
Results
Among the 749 Olmsted County women who received their first breast implants at the Mayo Clinic and fulfilled all the criteria for inclusion in this study, the reason for implantation was cosmetic for 532, related to cancer for 125, and related to prophylactic mastectomy for 92. The average age at the time of the initial implantation was 31, 49, and 40 years for the cosmetic, cancer, and prophylactic groups, respectively. These 749 women were followed for 5847 person-years (mean, 7.8 years; range, 0 to 25.8).
Surgical Procedures after Initial Implantation
After the initial implantations, 450 implant-related surgical procedures (including 23 two-stage operations, each of which was counted only once) were performed during follow-up. These procedures were performed in 208 women (27.8 percent) and involved 334 breasts (23 percent of the 1454 breasts with implants) and 394 implants (23.1 percent of the 1703 implants). Altogether, 818 indications were recorded for these 450 procedures, and many of the procedures were performed because of multiple indications. Among the 818 indications, 495 were classified as clinical and 323 as “other.”
Complications after Initial Implantation
Of the 450 procedures performed after initial implantation, 91 were performed as anticipated, staged procedures or because of the patient's request for a size change or aesthetic improvement. Of the remaining 359 procedures, 164 were performed solely for clinical reasons, and 195 involved both clinical and other indications. By definition, a clinical indication for a surgical procedure was considered a complication. Altogether, these complications occurred in 178 (23.8 percent) of the 749 women and involved 274 (18.8 percent) of the 1454 breasts with implants and 321 (18.8 percent) of the 1703 implants (Table 1Table 1
Indications for 450 Surgical Procedures in 208 Women (Involving 334 Breasts and 394 Implants) after Initial Breast Implantation.). Complications occurred in association with 19 percent of the 1465 implants containing silicone and 17 percent of the 238 other implants (P = 0.42). The most frequent complication was capsular contracture, followed by implant rupture, hematoma, and wound infection. Forty-three women (5.7 percent) had implant ruptures.Of the 178 women with complications, 70 (39.3 percent) had one complication, 74 (41.6 percent) had two, and 34 (19.1 percent) had three or more. Of the 274 breasts in which complications occurred, 212 (77.4 percent) each had one complication, 46 (16.8 percent) had two, and 16 (5.8 percent) had three or more. At least one complication developed in 321 of the 1703 implants. One complication occurred in 291 (90.7 percent), two in 24 (7.5 percent), and three or more in 6 (1.9 percent). In the implants with multiple complications, the earlier complications (such as hematoma drainage) were of the type that did not require permanent removal of the implant.
Complication Rate over Time
Data on the 321 first complications (of the total of 359) were used to assess the likelihood of a complication. Figure 1Figure 1
Cumulative Risk of Complications in 1703 Implants (Kaplan–Meier Estimate), According to the Reason for the Implantation. shows the Kaplan–Meier estimates of the cumulative risk of first complications among the 1703 implants according to the reason for the initial implantation (cosmetic, cancer-related, or prophylactic). For each group, the risk of complications was highest during the first few months after the insertion of the implant. Of all first complications, more than 50 percent occurred within the first year of follow-up, 75 percent by the third year, and 83 percent by the fifth year. Few individual implants were still being followed up after five years, and only a few new complications occurred each year thereafter. The maximal follow-up possible for the most recent implants was three or four years. Therefore, we analyzed the occurrence of complications within the first five years after the insertion of each implant.Predictors of the Complication Rate
The risks of a complication for the three implant groups differed over the follow-up period (Figure 1). Because the assumptions of the proportional-hazards model were not satisfied during the entire period of follow-up, we subdivided the follow-up into three periods after implantation and fit models assuming proportionality of hazards within these intervals. For the first 60 days after implantation, the rate of occurrence of a first complication ranged from 21.8 per 100 person-years (prophylactic group) to 25.3 per 100 person-years (cancer group) and did not differ significantly between the groups (Table 2Table 2
Complication Rates According to the Reason for Initial Implantation.). Consequently, the cumulative percentage of implants in which a first complication developed within 60 days was nearly identical for the three groups (Table 3Table 3
Estimated Cumulative Incidence of Complications, According to the Time after and Reason for Implantation.). During the period from 61 to 270 days after implantation, the rate of complications in the cosmetic group decreased to 3.6 per 100 person-years, and to 1.8 per 100 person-years thereafter. In contrast, the rates in the cancer and prophylactic groups continued at high levels from 61 to 270 days (29.0 and 24.9 per 100 person-years, respectively) after implantation, after which they decreased (to 5.7 and 4.5 per 100 person-years, respectively). Thus, the complication rates were significantly higher in the cancer and prophylactic groups than in the cosmetic group after 60 days (P<0.005). By five years after implantation, the percentage of implants with complications was nearly three times as high in the cancer and prophylactic groups as in the cosmetic group (Figure 1 and Table 3).Proportional-hazards models were fitted to assess the effects of five factors on the risk of a first complication after implantation. The reason for the initial implantation (P<0.001) and the age at implantation (P<0.001) were significant factors, whereas the date of implantation (P = 0.66), the number of previous implants (P = 0.30), and the number of previous complications (P = 0.20) were not. After adjustment for the reason for the initial implantation, age was no longer significant (P = 0.35), whereas the date of implantation (P = 0.09) was of marginal significance, with a trend toward lower complication rates in more recent years in the cosmetic group (Figure 2Figure 2
Cumulative Risk of Complications (Kaplan–Meier Estimate) among Women Who Underwent Breast Implantation for Cosmetic Reasons, According to the Date of Implantation.). After adjustment for the reason for implantation, the number of previous implants (P = 0.35) and the number of previous complications (P = 0.46) were still not significant predictors of the risk of a first complication.Mortality
Survival among the three cohorts is shown in Figure 3Figure 3
Survival (Kaplan–Meier Estimate) among Women Who Received Breast Implants, According to the Reason for the Implantation.. Patients in the cancer group had a much lower overall rate of survival than those in the other groups, even after adjustment for differences in age.Discussion
We previously compared the risks of connective-tissue and other autoimmune disorders among women living in Olmsted County who had breast implants with the risks in a control group of women who did not have implants. We found no significant differences in risk between the groups.3 Other studies have reported similar findings.14-18 The frequency of local complications in women with breast implants is also a source of concern.4-7 In the current study of the 749 Olmsted County women with implants, 23.8 percent had at least one local complication each after implantation, and additional surgical procedures, involving 18.8 percent of the 1454 implanted breasts, were necessary. The roughly 24 percent complication rate is essentially the same as that reported for autologous breast reconstruction.19 Complications were significantly less frequent after cosmetic implantation than after implantation following mastectomy for cancer or for cancer prophylaxis.
Most previous estimates of complication rates after breast implantation have been derived from referral-based case series that typically had relatively short periods of follow-up.20-27 In this study, we evaluated complications and surgical interventions in a population-based cohort of women with breast implants. Because of differences in the study groups (ours included patients with cancer, whereas previous studies did not; ours included the outcomes of operations done by several different surgeons, whereas others typically described the experience of one surgeon), in the definition of a complication (ours referred only to events that required surgical intervention, whereas other studies' definitions varied), and in the duration of follow-up, our results are not directly comparable with those of previous studies.20-27
Despite these differences, the complication rates we found were similar to or lower than those previously reported. For example, the estimated risks of a complication in the first 60 days were 3.7 percent, 4.0 percent, and 3.4 percent for the cosmetic, cancer, and prophylactic groups, respectively, which are similar to those in other reports.5,23 By five years, however, the overall risk increased to 12.0 percent, 34.0 percent, and 30.4 percent, respectively. The rates of leakage (occurring in 1.0 percent of the breasts with implants) and rupture (3.9 percent) in our study are much lower than previously reported rates.4,5,7 Similarly, only 17.5 percent of the women in our study underwent operations for capsular contracture, as compared with a rate of 37.6 percent for severe contracture in another recent study.6 The reported rates of postoperative complications in patients who had breast reconstruction with autologous tissue are similar to ours.19,28-30 Thus, breast reconstruction by any method is associated with a substantial risk of complications.
Our findings must be interpreted with several limitations in mind. Our data were based on a review of medical records and are susceptible to the limitations inherent in medical-records documentation. However, we defined complications as only the events that resulted in surgical intervention, and we could provide virtually complete ascertainment of such procedures, whether they were performed on an inpatient or an outpatient basis. Our ability to review the entire medical record (including all outpatient and inpatient reports by the local providers of medical care) and our detailed procedures helped ensure the completeness of the data on these events. However, the same cannot be said of other complications, which may be of less consequence. For example, we did not report all capsular contractures or hematomas, because many mild hematomas and contractures (which require no treatment) were probably considered unimportant by either the patient or her physician and therefore were not documented in the medical record. In fact, many of these do not even come to physicians' attention. We did not examine the effect of these events on the patients' overall health status and quality of life. We also did not evaluate the patients' overall satisfaction with their implants. Such data would add an important perspective to discussions about the proper role of breast implantation.
Supported by grants from the Plastic Surgery Educational Foundation, which is funded in part by breast-implant manufacturers, and the National Institutes of Health (AR30582).
We are indebted to Ms. Lee Bellrichard, Ms. Barbara Bryant, Ms. Jeannie Hill, and Ms. Ronda McCully for data collection; to Ms. Martha Mangan for assistance with the collection of data from the surgical records; to Ms. Joanne Benson for statistical analysis; and to Ms. LaDonna Corbin and Ms. Deborah Fogarty for their efforts in preparing the manuscript.
Source Information
From the Division of Rheumatology and Internal Medicine (S.E.G.), the Department of Health Sciences Research (S.E.G., W.M.O., C.M.B., L.T.K., L.J.M.), and the Division of Plastic Surgery (J.E.W.), Mayo Clinic and Mayo Foundation, Rochester, Minn.
Address reprint requests to Dr. Gabriel at the Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
- References
References
1
Deapen DM ,Pike MC ,Casagrande JT ,Brody GS . The relationship between breast cancer and augmentation mammaplasty: an epidemiologic study. Plast Reconstr Surg 1986;77:361-368
CrossRef | Web of Science | Medline2
May DS ,Stroup NE . The incidence of sarcomas of the breast among women in the United States, 1973-1986. Plast Reconstr Surg 1991;87:193-194
CrossRef | Web of Science | Medline3
Gabriel SE ,O'Fallon WM ,Kurland LT ,Beard CM ,Woods JE ,Melton LJ III . Risk of connective-tissue diseases and other disorders after breast implantation. N Engl J Med 1994;330:1697-1702
Full Text | Web of Science | Medline4
de Camara DL ,Sheridan JM ,Kammer BA . Rupture and aging of silicone gel breast implants. Plast Reconstr Surg 1993;91:828-834
CrossRef | Web of Science | Medline5
Peters W ,Keystone E ,Smith D . Factors affecting the rupture of silicone-gel breast implants. Ann Plast Surg 1994;32:449-451
CrossRef | Web of Science | Medline6
Worseg A ,Kuzbari R ,Tairych G ,Korak K ,Holle J . Long term results of inflatable mammary implants. Br J Plast Surg 1995;48:183-188
CrossRef | Medline7
Robinson OG Jr ,Bradley EL ,Wilson DS . Analysis of explanted silicone implants: a report of 300 patients. Ann Plast Surg 1995;34:1-6
CrossRef | Web of Science | Medline8
Gabriel SE ,O'Fallon WM ,Beard CM ,Kurland LT ,Woods JE ,Melton LJ III . Trends in the utilization of silicone breast implants, 1964-1991, and methodology for a population-based study of outcomes. J Clin Epidemiol 1995;48:527-537
CrossRef | Web of Science | Medline9
Melton LJ III . History of the Rochester Epidemiology Project. Mayo Clin Proc 1996;71:266-274
CrossRef | Web of Science | Medline10
Gabriel SE ,Melton LJ ,Woods JE ,O'Fallon WM ,Kurland LT . Silicone-containing breast implants and connective tissue diseases: a population-based retrospective cohort study. Arthritis Rheum 1993;36:Suppl:S70-S70 abstract.
CrossRef | Web of Science11
Lin DY ,Wei LJ . The robust inference for the Cox proportional hazards model. J Am Stat Assoc 1989;84:1074-1078
CrossRef | Web of Science12
Wei LJ ,Lin DY ,Weissfeld L . Regression analysis of multivariate incomplete failure time data by modeling marginal distributions. J Am Stat Assoc 1989;84:1065-1073
CrossRef | Web of Science13
Therneau TM. Extending the Cox model. Technical report series no. 58. Rochester, Minn.: Mayo Clinic, 1996.
14
Hochberg MC, Perlmutter DL, White B, et al. The association of augmentation mammoplasty with systemic sclerosis: results from a multi-center case-control study. Arthritis Rheum 1994;37:Suppl:S369. ab-stract.
15
Burns CG. The epidemiology of systemic sclerosis: a population-based case-control study. (Ph.D. thesis. Ann Arbor: University of Michigan, 1994.)
16
Strom BL ,Reidenberg MM ,Freundlich B ,Schinnar R . Breast silicone implants and risk of systemic lupus erythematosus. J Clin Epidemiol 1994;47:1211-1214
CrossRef | Web of Science | Medline17
Englert HJ ,Brooks P . Scleroderma and augmentation mammoplasty -- a causal relationship? Aust N Z J Med 1994;24:74-80
CrossRef | Medline18
Sanchez-Guerrero J ,Colditz GA ,Karlson EW ,Hunter DJ ,Speizer FE ,Liang MH . Silicone breast implants and the risk of connective-tissue diseases and symptoms. N Engl J Med 1995;332:1666-1670
Full Text | Web of Science | Medline19
Rosen PB ,Jabs AD ,Kister SJ ,Hugo NE . Clinical experience with immediate breast reconstruction using tissue expansion or transverse rectus abdominis musculocutaneous flaps. Ann Plast Surg 1990;25:249-257
CrossRef | Web of Science | Medline20
Hagerty RC ,Gould WL . Complications of augmentation mammaplasty and their treatment. J S C Med Assoc 1990;86:545-549
Medline21
LeRoy EC . Breast augmentation -- is there a risk? J S C Med Assoc 1990;86:556-558
Medline22
Baker JL Jr. Plastic surgery. 3rd ed. Boston: Little, Brown, 1979:719-31.
23
Pickering PP, Moore LT, Vecchione TR. Augmentation mammaplasty: a critique of favorable and unfavorable results. In: Owsley JQ Jr, Peterson RA, eds. Symposium on aesthetic surgery of the breast. St. Louis: C.V. Mosby, 1978:293-8.
24
Truppman ES, Ellenby JD. A 13-year evaluation of subpectoral augmentation mammaplasty. In: Owsley JQ Jr, Peterson RA, eds. Symposium on aesthetic surgery of the breast. St. Louis: C.V. Mosby, 1978:344-52.
25
Baker JL Jr. Augmentation mammaplasty. In: Owsley JQ Jr, Peterson RA, eds. Symposium on aesthetic surgery of the breast. St. Louis: C.V. Mosby, 1978:256-63.
26
Duffy MJ ,Woods JE . Health risks of failed silicone gel breast implants: a 30-year clinical experience. Plast Reconstr Surg 1994;94:295-299
CrossRef | Web of Science | Medline27
McGrath MH ,Burkhardt BR . The safety and efficacy of breast implants for augmentation mammaplasty. Plast Reconstr Surg 1984;74:550-560
CrossRef | Web of Science | Medline28
O'Brien W ,Hasselgren PO ,Hummel RP , et al. Comparison of postoperative wound complications and early cancer recurrence between patients undergoing mastectomy with or without immediate breast reconstruction. Am J Surg 1993;166:1-5
CrossRef | Web of Science | Medline29
Holley DT ,Toursarkissian B ,Vasconez HC , et al. The ramifications of immediate reconstruction in the management of breast cancer. Am Surg 1995;61:60-65
Web of Science | Medline30
Kroll SS ,Netscher DT . Complications of TRAM flap breast reconstruction in obese patients. Plast Reconstr Surg 1989;84:886-892
CrossRef | Web of Science | Medline
- Citing Articles (124)
Citing Articles
1
Davide Lazzeri, Tommaso Agostini, Guido Bocci, Giordano Giannotti, Giovanni Fanelli, Antonio Giuseppe Naccarato, Romano Danesi, Marco Tuccori, Marcello Pantaloni, Carlo D'Aniello. (2011) ALK-1–Negative Anaplastic Large Cell Lymphoma Associated With Breast Implants: A New Clinical Entity. Clinical Breast Cancer 11:5, 283-296
CrossRef2
Manuel Francisco Castello, Davide Lazzeri, Alessandro Silvestri, Tommaso Agostini, Christian Pascone, Claudio Marcelli, Diego Gigliotti, Carlo D’Aniello, Marco Gasparotti. (2011) Maximizing the Use of Precapsular Space and the Choice of Implant Type in Breast Augmentation Mammaplasty Revisions: Review of 49 Consecutive Procedures and Patient Satisfaction Assessment. Aesthetic Plastic Surgery 35:5, 828-838
CrossRef3
M. Pelzer, M.A. Reichenberger, G. Germann. (2011) Mikrochirurgische Brustrekonstruktion. Der Chirurg 82:9, 807-812
CrossRef4
Oonagh T. Hickey, Nora F. Nugent, Siun M. Burke, Parvaiz Hafeez, Aliaksandr L. Mudrakouski, George D. Shorten. (2011) Persistent pain after mastectomy with reconstruction. Journal of Clinical Anesthesia 23:6, 482-488
CrossRef5
Bradley Bengtson, Garry S. Brody, Mitchell H. Brown, Caroline Glicksman, Dennis Hammond, Hilton Kaplan, G. Patrick Maxwell, Michael G. Oefelein, Neal R. Reisman, Scott L. Spear, Mark L. Jewell. (2011) Managing Late Periprosthetic Fluid Collections (Seroma) in Patients with Breast Implants: A Consensus Panel Recommendation and Review of the Literature. Plastic and Reconstructive Surgery 128:1, 1-7
CrossRef6
Luca A. Dessy, Federico Corrias, Francesco Marchetti, Marco Marcasciano, Andrea F. Armenti, Marco Mazzocchi, Bruno Carlesimo. (2011) Implant Infection After Augmentation Mammaplasty: A Review of the Literature and Report of a Multidrug-Resistant Candida albicans Infection. Aesthetic Plastic Surgery
CrossRef7
Marco Mazzocchi, Luca A. Dessy, Federico Corrias, Nicolò Scuderi. (2011) A Clinical Study of Late Seroma in Breast Implantation Surgery. Aesthetic Plastic Surgery
CrossRef8
Philipp Alexander Bergmann, Thomas Lange, Frank Siemers, Hans-Günther Machens, Jörn Andreas Lohmeyer, Thomas Namdar, Peter Leonhard Stollwerck, Stefan Zimmermann, Peter Mailänder. (2011) Histological analysis of capsule formation around silicone implants and comparison with titanium-coated silicone implants in rats. European Journal of Plastic Surgery
CrossRef9
Steven M. Levine, Mary E. Lester, Benjamin Fontenot, Robert J. Allen. (2011) Perforator Flap Breast Reconstruction After Unsatisfactory Implant Reconstruction. Annals of Plastic Surgery 66:5, 513-517
CrossRef10
S. M. McHugh, C. J. Collins, M. A. Corrigan, A. D. K. Hill, H. Humphreys. (2011) The role of topical antibiotics used as prophylaxis in surgical site infection prevention. Journal of Antimicrobial Chemotherapy 66:4, 693-701
CrossRef11
Constance Neuhann-Lorenz, Josef Fedeles, Marita Eisenman-Klein, Brian Kinney, Bruce L. Cunningham. (2011) Eighth IQUAM Consensus Conference Position Statement: Transatlantic Innovations, April 2009. Plastic and Reconstructive Surgery 127:3, 1368-1375
CrossRef12
Pablo Rivera, Robert Dryden. (2011) Bilateral Transaxillary Subfascial Breast Augmentation With Smooth Saline Implants: A Retrospective Analysis of Short-Term Complications. American Journal of Cosmetic Surgery 28:1, 29-36
CrossRef13
S. Potter, A. Brigic, P. F. Whiting, S. J. Cawthorn, K. N. L. Avery, J. L. Donovan, J. M. Blazeby. (2011) Reporting Clinical Outcomes of Breast Reconstruction: A Systematic Review. JNCI Journal of the National Cancer Institute 103:1, 31-46
CrossRef14
Judit E. Puskas, Matthew T. Luebbers. (2011) Breast implants: the good, the bad and the ugly. Can nanotechnology improve implants?. Wiley Interdisciplinary Reviews: Nanomedicine and Nanobiotechnologyn/a-n/a
CrossRef15
Timothy A. Schaub, Jamil Ahmad, Rod J. Rohrich. (2010) Capsular Contracture with Breast Implants in the Cosmetic Patient: Saline versus Silicone–A Systematic Review of the Literature. Plastic and Reconstructive Surgery 126:6, 2140-2149
CrossRef16
Liz Lostumbo, Nora E Carbine, Judi Wallace, Liz Lostumbo. 2010. Prophylactic mastectomy for the prevention of breast cancer. .
CrossRef17
Marisa Marques, Spencer A. Brown, Isabel Oliveira, M. Natália D. S. Cordeiro, Aliuska Morales-Helguera, Acácio Rodrigues, José Amarante. (2010) Long-Term Follow-Up of Breast Capsule Contracture Rates in Cosmetic and Reconstructive Cases. Plastic and Reconstructive Surgery 126:3, 769-778
CrossRef18
Evan M. Feldman, Dimitrios P. Kontoyiannis, Safa E. Sharabi, Edward Lee, Yoav Kaufman, Lior Heller. (2010) Breast Implant Infections: Is Cefazolin Enough?. Plastic and Reconstructive Surgery 126:3, 779-785
CrossRef19
2010. Rationale for Biofilm Eradication from Modern Medical Devices. , 36-72.
CrossRef20
Noortje J. Visser, Tim H. C. Damen, Reinier Timman, Stefan O. P. Hofer, Marc A. M. Mureau. (2010) Surgical Results, Aesthetic Outcome, and Patient Satisfaction after Microsurgical Autologous Breast Reconstruction following Failed Implant Reconstruction. Plastic and Reconstructive Surgery 126:1, 26-36
CrossRef21
Kotaro Yoshimura, Yuko Asano, Noriyuki Aoi, Masakazu Kurita, Yoshio Oshima, Katsujiro Sato, Keita Inoue, Hirotaka Suga, Hitomi Eto, Harunosuke Kato, Kiyonori Harii. (2010) Progenitor-Enriched Adipose Tissue Transplantation as Rescue for Breast Implant Complications. The Breast Journal 16:2, 169-175
CrossRef22
Judit E. Puskas, Elizabeth A. Foreman-Orlowski, Goy Teck Lim, Sara E. Porosky, Michelle M. Evancho-Chapman, Steven P. Schmidt, Mirosława El Fray, Marta Piątek, Piotr Prowans, Krystal Lovejoy. (2010) A nanostructured carbon-reinforced polyisobutylene-based thermoplastic elastomer. Biomaterials 31:9, 2477-2488
CrossRef23
Malcolm A. Lesavoy, Andrew P. Trussler, Brian P. Dickinson. (2010) Difficulties with Subpectoral Augmentation Mammaplasty and Its Correction: The Role of Subglandular Site Change in Revision Aesthetic Breast Surgery. Plastic and Reconstructive Surgery 125:1, 363-371
CrossRef24
Amy K. Alderman, E Dale Collins, Rachel Streu, James C. Grotting, Amy L. Sulkin, Peter Neligan, Phillip C. Haeck, Karol A. Gutowski. (2009) Benchmarking Outcomes in Plastic Surgery: National Complication Rates for Abdominoplasty and Breast Augmentation ‘Outcomes Article]. Plastic and Reconstructive Surgery 124:6, 2127-2133
CrossRef25
Gitte B. Hvilsom, Lisbet R. Hölmich, Trine F. Henriksen, Loren Lipworth, Joseph K. McLaughlin, Søren Friis. (2009) Local Complications after Cosmetic Breast Augmentation: Results from the Danish Registry for Plastic Surgery of the Breast. Plastic and Reconstructive Surgery 124:3, 919-925
CrossRef26
W. Maarse, Y. Jonasse, M.G.E.M. Ausems, M.E.I. Schipper, R. van Hillegersberg. (2009) First case of invasive breast cancer following prophylactic bilateral skin sparing mastectomy in a BRCA1 mutation carrier. European Journal of Surgical Oncology (EJSO) 35:9, 1016-1018
CrossRef27
Philip Pfeiffer, Signe Jørgensen, Thomas B. Kristiansen, Anna Jørgensen, Lisbet R. Hölmich. (2009) Protective Effect of Topical Antibiotics in Breast Augmentation. Plastic and Reconstructive Surgery 124:2, 629-634
CrossRef28
Dietmar Ulrich, Franziska Ulrich, Norbert Pallua, Marita Eisenmann-Klein. (2009) Effect of Tissue Inhibitors of Metalloproteinases and Matrix Metalloproteinases on Capsular Formation Around Smooth and Textured Silicone Gel Implants. Aesthetic Plastic Surgery 33:4, 555-562
CrossRef29
Antonino Araco, Roberto Sorge, John Overton, Francesco Araco, Gianpiero Gravante. (2009) Postbariatric Patients Undergoing Body-Contouring Abdominoplasty. Annals of Plastic Surgery 62:6, 613-617
CrossRef30
U. M. Rieger, G. Pierer, N. J. Lüscher, A. Trampuz. (2009) Sonication of Removed Breast Implants for Improved Detection of Subclinical Infection. Aesthetic Plastic Surgery 33:3, 404-408
CrossRef31
Robin L. Nabi. (2009) Cosmetic Surgery Makeover Programs and Intentions to Undergo Cosmetic Enhancements: A Consideration of Three Models of Media Effects. Human Communication Research 35:1, 1-27
CrossRef32
C. Nestle-Krämling, W. Janni. (2008) Plastisch-rekonstruktive Operationen bei Mammakarzinom. Der Onkologe 14:12, 1281-1292
CrossRef33
O. Bettendorf, H. Schmidt, E. Eltze, A. Rody, F. Herchenröder, C. Jackisch, W. Böcker, B. Pfleiderer. (2008) Quantitative measurement of telomerase activity and localization of its catalytic subunit (hTERT) in chronic inflammation of capsule formation around various model implants and in sarcomas in a rat model. Journal of Biomedical Materials Research Part A 85A:3, 646-650
CrossRef34
A L. van Rijssen, Han Wilmink, Jan J. van Wingerden, Berend van der Lei. (2008) Amorous Squeezing of the Augmented Breast May Result in Late Capsular Hematoma Formation. Annals of Plastic Surgery 60:4, 375-378
CrossRef35
Bernard S. Alpert, Donald H. Lalonde. (2008) MOC-PS(SM) CME Article: Breast Augmentation. Plastic and Reconstructive Surgery 121:Supplement, 1-7
CrossRef36
Louise A. Brinton. (2007) The Relationship of Silicone Breast Implants and Cancer at Other Sites. Plastic and Reconstructive Surgery 120:Supplement 1, 94S-102S
CrossRef37
Lisbet R. Hölmich, Vibeke B. Breiting, Jon P. Fryzek, Bodil Brandt, Mette S. Wolthers, Kim Kjøller, Joseph K. McLaughlin, Søren Friis. (2007) Long-Term Cosmetic Outcome After Breast Implantation. Annals of Plastic Surgery 59:6, 597-604
CrossRef38
Scott L. Spear, Diane K. Murphy, Araceli Slicton, Patricia S. Walker. (2007) Inamed Silicone Breast Implant Core Study Results at 6 Years. Plastic and Reconstructive Surgery 120:Supplement 1, 8S-16S
CrossRef39
Thomas J. Gampper, Habib Khoury, Wendy Gottlieb, Raymond F. Morgan. (2007) Silicone Gel Implants in Breast Augmentation and Reconstruction. Annals of Plastic Surgery 59:5, 581-590
CrossRef40
Ramazan Erkin Unlu, Asu Deniz Yilmaz, Hakan Orbay, Belgin Can, Ibrahim Tekdemir, Omer Sensoz. (2007) Influence of Rifampin on Capsule Formation Around Silicone Implants in a Rat Model. Aesthetic Plastic Surgery 31:4, 358-364
CrossRef41
A. Araco, G. Gravante, F. Araco, D. Delogu, V. Cervelli, K. Walgenbach. (2007) Infections of Breast Implants in Aesthetic Breast Augmentations: A Single-Center Review of 3,002 Patients. Aesthetic Plastic Surgery 31:4, 325-329
CrossRef42
Penel Nicolas, Yazdanpanah Yazdan, Chauvet Marie-Pierre, Clisant Stéphanie, Giard Sylvia, Neu Jean-Charles, Lefebvre Danièle, Fournier Charles, Bonneterre Jacques. (2007) Prevention of surgical site infection after breast cancer surgery by targeted prophylaxis antibiotic in patients at high risk of surgical site infection. Journal of Surgical Oncology 96:2, 124-129
CrossRef43
M.J. Bermejo-Pérez, S. Márquez-Calderón, A. Llanos-Méndez. (2007) Effectiveness of preventive interventions inBRCA1/2 gene mutation carriers: A systematic review. International Journal of Cancer 121:2, 225-231
CrossRef44
Lukas Prantl, Stephan Schreml, Stefan Fichtner-Feigl, Nina P??ppl, Marita Eisenmann-Klein, Hartmut Schwarze, Bernd F??chtmeier. (2007) Clinical and Morphological Conditions in Capsular Contracture Formed around Silicone Breast Implants. Plastic and Reconstructive Surgery 120:1, 275-284
CrossRef45
Alexander Anzarut, Craig R. Guenther, David C. Edwards, Ross T. Tsuyuki. (2007) Completely Autologous Platelet Gel in Breast Reduction Surgery: A Blinded, Randomized, Controlled Trial. Plastic and Reconstructive Surgery 119:4, 1159-1166
CrossRef46
Shaheen Zakaria, Amy C. Degnim. (2007) Prophylactic Mastectomy. Surgical Clinics of North America 87:2, 317-331
CrossRef47
Casey Isom, Vishal Kapoor, Lynne Wilson, Carrie Fathke, Leigh Barnes, Stephen R. Sullivan, F Frank Isik. (2007) Breast Implant Capsules Are Partially Composed of Bone Marrow???Derived Cells. Annals of Plastic Surgery 58:4, 377-380
CrossRef48
Y. Nancy You, Vipul T. Lakhani, Samuel A. Wells. (2007) The Role of Prophylactic Surgery in Cancer Prevention. World Journal of Surgery 31:3, 450-464
CrossRef49
Neal Handel. (2006) Secondary Mastopexy in the Augmented Patient: A Recipe for Disaster. Plastic and Reconstructive Surgery 118:Supplement, 152S-163S
CrossRef50
Chin-Ho Wong, Miny Samuel, Bien-Keem Tan, Colin Song. (2006) Capsular Contracture in Subglandular Breast Augmentation with Textured versus Smooth Breast Implants: A Systematic Review. Plastic and Reconstructive Surgery 118:5, 1224-1236
CrossRef51
R. Ortega, I. Gómez de Travecedo, J.C. Hermoso. (2006) Absceso mamario tardío tras la colocación de un implante. Clínica e Investigación en Ginecología y Obstetricia 33:5, 199-201
CrossRef52
Alon Zahavi, Miri Levi Sklair, Dean D. Ad-El. (2006) Capsular Contracture of the Breast. Annals of Plastic Surgery 57:3, 248-251
CrossRef53
Lukas Prantl, Peter Angele, Stefan Schreml, Dietmar Ulrich, Nina P??ppl, Marita Eisenmann-Klein. (2006) Determination of Serum Fibrosis Indexes in Patients with Capsular Contracture after Augmentation with Smooth Silicone Gel Implants. Plastic and Reconstructive Surgery 118:1, 224-229
CrossRef54
E. J. F. Reij, J. P. A. Nicolai. (2006) Revision operations after silicone gel breast implantation: a retrospective study. European Journal of Plastic Surgery 29:1, 22-26
CrossRef55
Kenneth C. Shestak, Morad Askari. (2006) A Simple Barrier Drape for Breast Implant Placement. Plastic and Reconstructive Surgery 117:6, 1722-1723
CrossRef56
I. S. Fentiman, H. Hamed. (2006) Breast reconstruction. International Journal of Clinical Practice 60:4, 471-474
CrossRef57
Louise A. Brinton, Jay H. Lubin, Mary Cay Murray, Theodore Colton, Robert N. Hoover. (2006) Mortality Rates Among Augmentation Mammoplasty Patients. Epidemiology 17:2, 162-169
CrossRef58
Neal Handel, Tracy Cordray, Jaime Gutierrez, J Arthur Jensen. (2006) A Long-Term Study of Outcomes, Complications, and Patient Satisfaction with Breast Implants. Plastic and Reconstructive Surgery 117:3, 757-767
CrossRef59
Wulf Siggelkow, Antje Lebrecht, Heinz Kölbl, Andre Faridi. (2005) Dual-plane implant positioning for capsular contracture of the breast in combination with mastopexy. Archives of Gynecology and Obstetrics 273:2, 79-85
CrossRef60
L. Prantl, N. Pöppl, N. Horvat, N. Heine, M. Eisenmann-Klein. (2005) Serologic and Histologic Findings in Patients with Capsular Contracture After Breast Augmentation with Smooth Silicone Gel Implants: Is Serum Hyaluronan a Potential Predictor?. Aesthetic Plastic Surgery 29:6, 510-518
CrossRef61
Claudio De Lorenzi. (2005) Successful Treatment of Acute Periprosthetic Breast Infection with Curettage, Pulse Lavage, and Immediate Device Exchange. Aesthetic Plastic Surgery 29:5, 400-403
CrossRef62
Maurizio Cavallini, Franz Wilhelm Baruffaldi Preis, Andrea Casati. (2005) Effects of Mild Hypothermia on Blood Coagulation in Patients Undergoing Elective Plastic Surgery. Plastic and Reconstructive Surgery 116:1, 316-321
CrossRef63
Trine F. Henriksen, Jon P. Fryzek, Lisbet R. H??lmich, Joseph K. McLaughlin, Kim Kj??ller, Annette Pernille H??yer, J??rgen H. Olsen, S??ren Friis. (2005) Surgical Intervention and Capsular Contracture After Breast Augmentation. Annals of Plastic Surgery 54:4, 343-351
CrossRef64
Scott L. Spear, Mary Ella Carter, Karl Schwarz. (2005) Prophylactic Mastectomy: Indications, Options, and Reconstructive Alternatives. Plastic and Reconstructive Surgery 115:3, 891-909
CrossRef65
Brigitte Pittet, Denys Montandon, Didier Pittet. (2005) Infection in breast implants. The Lancet Infectious Diseases 5:2, 94-106
CrossRef66
Niki J. Agnantis, Evangelos Paraskevaidis, Dimitrios Roukos. (2004) Preventing Breast, Ovarian Cancer in BRCA Carriers: Rational of Prophylactic Surgery and Promises of Surveillance. Annals of Surgical Oncology 11:12, 1030-1034
CrossRef67
Ilona Kulmala, Joseph K. McLaughlin, Matti Pakkanen, Kai Lassila, Lisbet R. Hölmich, Loren Lipworth, John D. Boice, Jani Raitanen, Riitta Luoto. (2004) Local Complications After Cosmetic Breast Implant Surgery in Finland. Annals of Plastic Surgery 53:5, 413-419
CrossRef68
Liz Lostumbo, Nora E Carbine, Judi Wallace, Jeanette Ezzo, Kay Dickersin, Liz Lostumbo. 2004. Prophylactic mastectomy for the prevention of breast cancer. .
CrossRef69
Sean C. Dowdy, Michael Stefanek, Lynn C. Hartmann. (2004) Surgical risk reduction: Prophylactic salpingo-oophorectomy and prophylactic mastectomy. American Journal of Obstetrics and Gynecology 191:4, 1113-1123
CrossRef70
Robert E. Tarone, Loren Lipworth, V. Leroy Young, Joseph K. McLaughlin. (2004) Breast Reduction Surgery and Breast Cancer Risk: Does Reduction Mammaplasty Have a Role in Primary Prevention Strategies for Women at High Risk of Breast Cancer?. Plastic and Reconstructive Surgery 113:7, 2104-2110
CrossRef71
Victor Pineda, Jos?? C??ceres, Juan Carlos Pernas, Jordi Catal??. (2004) Retromammary Fluid Collection as a Late Complication of Breast Implants. Journal of Computer Assisted Tomography 28:3, 386-389
CrossRef72
Janos Fodor, Nora Udvarhelyi, Gusztav Gulyas, Miklos Kasler. (2004) OSSIFYING CALCIFICATION OF BREAST IMPLANT CAPSULE. Plastic and Reconstructive Surgery 113:6, 1880-1882
CrossRef73
Darouiche, Rabih O., . (2004) Treatment of Infections Associated with Surgical Implants. New England Journal of Medicine 350:14, 1422-1429
Full Text74
W Siggelkow, B Klosterhalfen, U Klinge, W Rath, A Faridi. (2004) Analysis of local complications following explantation of silicone breast implants. The Breast 13:2, 122-128
CrossRef75
Fereydoun Don Parsa, Andrew Hsu, Natalie N. Parsa. (2004) Late Extrusion of Saline Prostheses after Aesthetic Breast Augmentation. Plastic and Reconstructive Surgery 113:4, 1270-1274
CrossRef76
Preston J. Chandler. (2004) Talc and Capsular Contracture. Annals of Plastic Surgery 52:3, 288-292
CrossRef77
Jillian Banbury, Randall Yetman, Armand Lucas, Francis Papay, Karen Graves, James E. Zins. (2004) Prospective Analysis of the Outcome of Subpectoral Breast Augmentation: Sensory Changes, Muscle Function, and Body Image. Plastic and Reconstructive Surgery 113:2, 701-707
CrossRef78
Trine F. Henriksen, Lisbet R. H??lmich, Jon P. Fryzek, S??ren Friis, Joseph K. McLaughlin, Annette Pernille H??yer, Kim Kj??ller, J??rgen H. Olsen. (2003) Incidence and Severity of Short-Term Complications After Breast Augmentation. Annals of Plastic Surgery 51:6, 531-539
CrossRef79
Sara M. Zion, Jeffrey M. Slezak, Thomas A. Sellers, John E. Woods, Phillip G. Arnold, Paul M. Petty, John H. Donohue, Marlene H. Frost, Daniel J. Schaid, Lynn C. Hartmann. (2003) Reoperations after prophylactic mastectomy with or without implant reconstruction. Cancer 98:10, 2152-2160
CrossRef80
Scott L. Spear, Mary Ella Carter, Jason C. Ganz. (2003) The Correction of Capsular Contracture by Conversion to “Dual-Plane” Positioning: Technique and Outcomes. Plastic and Reconstructive Surgery 112:2, 456-466
CrossRef81
E. Eltze, O. Bettendorf, A. Rody, C. Jackisch, F. Herchenr
der, W. B
CrossRef82
MINDY SMITH, KAREN KENT. (2002) Breast Concerns and Lifestyles of Women. Clinical Obstetrics and Gynecology 45:4, 1129-1139
CrossRef83
Dimitrios H. Roukos, Niki J. Agnanti, Evangelos Paraskevaidis, Angelos M. Kappas. (2002) Approaching the dilemma between prophylactic bilateral mastectomy or oophorectomy for breast and ovarian cancer prevention in carriers ofBRCA1 orBRCA2 mutations. Annals of Surgical Oncology 9:10, 941-943
CrossRef84
Scott L. Spear, Andrew J. Wolfe. (2002) The Coincidence of TRAM Flaps and Prostheses in the Setting of Breast Reconstruction. Plastic and Reconstructive Surgery 110:2, 478-486
CrossRef85
Kauff, Noah D., Satagopan, Jaya M., Robson, Mark E., Scheuer, Lauren, Hensley, Martee, Hudis, Clifford A., Ellis, Nathan A., Boyd, Jeff, Borgen, Patrick I., Barakat, Richard R., Norton, Larry, Castiel, Mercedes, Nafa, Khedoudja, Offit, Kenneth, . (2002) Risk-Reducing Salpingo-oophorectomy in Women with a BRCA1 or BRCA2 Mutation. New England Journal of Medicine 346:21, 1609-1615
Full Text86
S. Lori Brown. (2002) Epidemiology of Silicone-Gel Breast Implants. Epidemiology 13:Supplement, S34-S39
CrossRef87
Thomas F. Cash, Lois A. Duel, Laura L. Perkins. (2002) Women’s Psychosocial Outcomes of Breast Augmentation with Silicone Gel-Filled Implants: A 2-Year Prospective Study. Plastic and Reconstructive Surgery 109:6, 2112-2121
CrossRef88
S. Lori Brown, Gene Pennello. (2002) Replacement Surgery and Silicone Gel Breast Implant Rupture: Self-Report by Women after Mammoplasty. Journal of Women's Health & Gender-Based Medicine 11:3, 255-264
CrossRef89
Kim Kj??ller, Lisbet R. H??lmich, Poul Harboe Jacobsen, S??ren Friis, Jon Fryzek, Joseph K. McLaughlin, Loren Lipworth, Trine F. Henriksen, Signe J??rgensen, Sven Bittmann, J??rgen H. Olsen. (2002) Epidemiological Investigation of Local Complications After Cosmetic Breast Implant Surgery in Denmark. Annals of Plastic Surgery 48:3, 229-237
CrossRef90
Marguerite E. Aitken, Thomas A. Mustoe. (2002) Why Change a Good Thing? Revisiting the Fleur-de-Lis Reconstruction of the Breast. Plastic and Reconstructive Surgery 109:2, 525-533
CrossRef91
Daniel J. Cher, Jennifer A. Conwell, Jack S. Mandel. (2001) MRI for Detecting Silicone Breast Implant Rupture: Meta-analysis and Implications. Annals of Plastic Surgery 47:4, 367-380
CrossRef92
Kim Kj??ller, Lisbet R. H??lmich, Poul Harboe Jacobsen, S??ren Friis, Jon Fryzek, Joseph K. McLaughlin, Loren Lipworth, Trine F. Henriksen, Signe J??rgensen, Sven Bittmann, J??rgen H. Olsen. (2001) Capsular Contracture After Cosmetic Breast Implant Surgery in Denmark. Annals of Plastic Surgery 47:4, 359-366
CrossRef93
H.A. Cense, E.J.Th. Rutgers, M. Lopes Cardozo, J.J.B. Van Lanschot. (2001) Nipple-sparing mastectomy in breast cancer: a viable option?. European Journal of Surgical Oncology (EJSO) 27:6, 521-526
CrossRef94
Nancy de Kleer, Meir Cohen, John Semple, Andrew Simor, Oleh Antonyshyn. (2001) Nipple Piercing May be Contraindicated in Male Patients With Chest Implants. Annals of Plastic Surgery 47:2, 188-190
CrossRef95
Meijers-Heijboer, Hanne, van Geel, Bert, van Putten, Wim L.J., Henzen-Logmans, Sonja C., Seynaeve, Caroline, Menke-Pluymers, Marian B.E., Bartels, Carina C.M., Verhoog, Leon C., van den Ouweland, Ans M.W., Niermeijer, Martinus F., Brekelmans, Cecile T.M., Klijn, Jan G.M., . (2001) Breast Cancer after Prophylactic Bilateral Mastectomy in Women with a BRCA1 or BRCA2 Mutation. New England Journal of Medicine 345:3, 159-164
Full Text96
Ruth Warren. (2001) Screening women at high risk of breast cancer on the basis of evidence. European Journal of Radiology 39:1, 50-59
CrossRef97
Krishna B. Clough, Joseph M. O’Donoghue, Alfred D. Fitoussi, Claude Nos, Marie-Christine Falcou. (2001) Prospective Evaluation of Late Cosmetic Results following Breast Reconstruction: I. Implant Reconstruction. Plastic and Reconstructive Surgery 107:7, 1702-1709
CrossRef98
Krishna B. Clough, Joseph M. O’Donoghue, Alfred D. Fitoussi, Georges Vlastos, Marie-Christine Falcou. (2001) Prospective Evaluation of Late Cosmetic Results following Breast Reconstruction: II. TRAM Flap Reconstruction. Plastic and Reconstructive Surgery 107:7, 1710-1716
CrossRef99
Stephanie Byram, Baruch Fischhoff, Martha Embrey, Wandi Bruine de Bruin, Sarah Thorne. (2001) Mental Models of Women With Breast Implants: Local Complications. Behavioral Medicine 27:1, 4-14
CrossRef100
Jon P. Fryzek, Lisa B. Signorello, Lars Hakelius, Loren Lipworth, Joseph K. McLaughlin, William J. Blot, Olof Nyren. (2001) Local Complications and Subsequent Symptom Reporting among Women with Cosmetic Breast Implants. Plastic and Reconstructive Surgery 107:1, 214-221
CrossRef101
C.M.E. Contant, A.N. van Geel, B. van der Holt, C. Griep, R. Tjong Joe Wai, Th. Wiggers. (2000) Morbidity of immediate breast reconstruction (IBR) after mastectomy by a subpectorally placed silicone prosthesis:the adverse effect of radiotherapy. European Journal of Surgical Oncology (EJSO) 26:4, 344-350
CrossRef102
A. Iorwerth, R. Cochrane, D.J.T. Webster. (2000) Chronic haematoma as a late complication of cosmetic breast augmentation. The Breast 9:3, 158-160
CrossRef103
C. Lin Puckett. (2000) On the Safety of Silicone Gel Breast Implants. Cancer Investigation 18:3, 278-280
CrossRef104
Kevin S. Hughes, Moshe Z. Papa, Timothy Whitney, Robert McLellan. (1999) Prophylactic mastectomy and inherited predisposition to breast carcinoma. Cancer 86:S11, 2502-2516
CrossRef105
Eric Siceloff, Greg Blasko, Bruce Rothschild. (1999) Breast implants and fibromyalgia. Comprehensive Therapy 25:11-12, 479-491
CrossRef106
Kevin S. Hughes, Moshe Z. Papa, Timothy Whitney, Robert McLellan. (1999) Prophylactic mastectomy and inherited predisposition to breast carcinoma. Cancer 86:S8, 1682-1696
CrossRef107
SIRPA-LIISA HOVI, ELINA HEMMINKI, SHANNA H. SWAN. (1999) Cosmetic and Postmastectomy Breast Implants: Finnish Women's Experiences. Journal of Women's Health & Gender-Based Medicine 8:7, 933-939
CrossRef108
Lu-Jean Feng, Saeid B. Amini. (1999) Analysis of Risk Factors Associated with Rupture of Silicone Gel Breast Implants. Plastic & Reconstructive Surgery 104:4, 955-963
CrossRef109
Leslie L. Montgomery, Katherine N. Tran, Melissa C. Heelan, Kimberly J. Zee, Mary Jane Massie, David K. Payne, Patrick I. Borgen. (1999) Issues of Regret in Women With Contralateral Prophylactic Mastectomies. Annals of Surgical Oncology 6:6, 546-552
CrossRef110
V L Roger, S J Jacobsen, S A Weston, K R Bailey, T E Kottke, R L Frye. (1999) Trends in heart disease deaths in Olmsted County, Minnesota, 1979-1994.. Mayo Clinic Proceedings 74:7, 651-657
CrossRef111
Howard A. Palley, Marian Lief Palley. (1999) The Regulatory Process, the Food and Drug Administration, and the Silicone Breast Implant Controversy. Journal of Health & Social Policy 11:1, 1-20
CrossRef112
James S. Marotta, Christopher W. Widenhouse, Mutaz B. Habal, Eugene P. Goldberg. (1999) Silicone gel breast implant failure and frequency of additional surgeries: Analysis of 35 studies reporting examination of more than 8000 explants. Journal of Biomedical Materials Research 48:3, 354-364
CrossRef113
V. Leroy Young, Walter Peters, Harold J. Brandon, Kenneth L. Jerina, Clarence J. Wolf. (1998) DETERMINING THE FREQUENCY OF BREAST IMPLANT FAILURE REQUIRES SOUND SCIENTIFIC PRINCIPLES. Plastic & Reconstructive Surgery 102:4, 1295-1299
CrossRef114
Eugene P. Goldberg, Christopher Widenhouse, James Marotta, Paul Martin. (1998) DETERMINING THE FREQUENCY OF BREAST IMPLANT FAILURE REQUIRES SOUND SCIENTIFIC PRINCIPLES. Plastic & Reconstructive Surgery 102:4, 1299-1301
CrossRef115
Jeffrey E. Gershenwald, Kelly K. Hunt, Stephen S. Kroll, Merrick I. Ross, Bonnie J. Baldwin, Barry W. Feig, Frederick C. Ames, Mark A. Schusterman, S. Eva Singletary. (1998) Synchronous elective contralateral mastectomy and immediate bilateral breast reconstruction in women with early-stage breast cancer. Annals of Surgical Oncology 5:6, 529-538
CrossRef116
M.K. Roy, S. Shrotia, C. Holcombe, D.J.T. Webster, L.E. Hughes, R.E. Mansel. (1998) Complications of latissimus dorsi myocutaneous flap breast reconstruction. European Journal of Surgical Oncology (EJSO) 24:3, 162-165
CrossRef117
Edward P. Melmed. (1998) A Review of Explantation in 240 Symptomatic Women: A Description of Explantation and Capsulectomy with Reconstruction Using a Periareolar Technique. Plastic & Reconstructive Surgery 101:5, 1364-1373
CrossRef118
Ralph R. Cook, Susan J. Hoshaw, Laura L. Perkins. (1998) FAILURE OF SILICONE GEL BREAST IMPLANTS: ANALYSIS OF LITERATURE DATA FOR 1652 EXPLANTED PROSTHESES. Plastic & Reconstructive Surgery 101:4, 1162
CrossRef119
Ralph R Cook, James M Curtis, Laura L Perkins, Susan J Hoshaw. (1998) Rupture of silicone-gel breast implants. The Lancet 351:9101, 520-521
CrossRef120
(1998) Letters to the Editor. Journal of Nutritional and Environmental Medicine 8:4, 367-379
CrossRef121
Jefferson E. C. Moulds, Christine D. Berg. (1998) Radiation therapy and breast reconstruction. Radiation Oncology Investigations 6:2, 81-89
CrossRef122
Edward P. Melmed. (1997) Reply: Breast Capsular Contracture. Plastic & Reconstructive Surgery 100:6, 1619
CrossRef123
Black, Bert, . (1997) Subpoenas and Science — When Lawyers Force Their Way into the Laboratory. New England Journal of Medicine 336:10, 725-727
Full Text124
Mathes, Stephen J., . (1997) Breast Implantation — The Quest for Safety and Quality. New England Journal of Medicine 336:10, 718-719
Full Text
