Reconstruction mammaire par prothese anatomique gonflable. Etude retrospective de 65 cas

This study reports the first mammary reconstruction series with anatomic saline implants after mastectomy for breast cancer. 65 patients were reviewed with a 10-month follow-up. The authors used Mac Gahn anatomic saline implant style 468 or 363. The contralateral breast mammaplasty for symmetrisation was performed in 53 patients, usually during implantation of the implant. The nipple areola reconstruction was usually performed with full thickness' skin graft and Little's flap. The implants, (average volume of 275 ml before changing), were changed for 17 patients, because of insufficient reconstruction or an excessively high mammary fold. The most frequent complication was pain, despite morphine protocols (19 patients). These were a cases of 9 rippling; but only a small percentage of internal dimple (4 patients). Patient and surgeon satisfaction was rated (1-20) and classified into three levels. In conclusion, the advantages of anatomic saline implants are: to avoid some symmetrisations, reconstruction of a stable breast, to avoid internal dimple. The disadvantages are: persistent rippling, specific learning for their implantation and difficulty of the choice of size.