Objectives: Poner a consideracion nuestra conducta en la explantacion de Implantes Mamarios, en pacientes que no desean continuar con los mismos.
Alternativas quirurgicas y evolucion.

Introduction: Numerosas pacientes concurren a la consulta a los efectos de retiro de implantes, como consecuencia de contracturas capsulares de larga data, extrusion post aumento o reconstruccion mamaria, o con temor de la presencia de Linfoma Anaplasico de Celulas Gigantes .
Lo que implica una reduccion drastica de volumen, asi como la consecuente exceso de tejido cutaneo, lo que amerita una reubicacion de este ultimo, y devolver un volumen aceptable desde el punto de vista estetico.

Materials / method: Se presenta la experiencia del Servicio de Cirugia Plastica del Parque de la Salud (asistencial sin cobertura), y la Clinica de Cirugia Plastica del autor, de pacientes que consultaron post reconstruccion mamaria post Cancer de mama, malformaciones Congenitas, asi como mastoplastias esteticas en los ultimos 10 años.-

Results: La indicacion del procedimiento adecuado para devolver volumen y posicion a aquellas pacientes en las que se les realizo retiro de implantes por deseo de las misma, extrusion del implante, rotura intracapsular, contractura baker grado III - IV, con temor de desarrollar Linfoma Anaplasico de Celulas Gigantes, etc.

Conclusion: La solucion de acuerdo al grado de deformidad ocasionada por el retiro de volumen (implante), y el reemplazo del mismo , asi como el reposicionamiento, es un desafio del Cirujano Plastico, ameritando la utilizacion de aquellas estrategias y tecnicas quirurgicas que garantizen un resultado estetico satisfactorio.

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Objectives: This review and analysis of studies permits to place our personal experience in breast implant surgery in a scientific framework concerning factors potentially influencing the development of capsular contracture.

Introduction: We 'll present an overview and analysis of literature concerning capsular contracture

Materials / method: Published studies are analysed , concerning influencing factors of evolution of capsular contracture after breast implant surgery : infection, influence of implant envelope ( textured, smooth) , position of the implant ( subglandular, subfacial, dual plane, submuscular,) , incision ( areola, submammary fold, axillar), genetique factors etc.

Results: Capsular contracture is a multifactorial caused complication of breast implant surgery with a higher incidence than often believed.

Conclusion: For our patients and as plastic surgeons we need to be “updated” about science and myths of capsular contracture and possible techniques to lower potentially the complication rate.

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Objectives: Description of a safety technique to correct severe ptosis in gigantomastia: a dermal enlarged flap to avoid nipple graft

Introduction: Surgery to reduce gigantomastia and severe ptosis requires notable lifting of the areola and runs the risk of its necrosis. Areolar grafting is often the solution. We devised a mammaplasty technique with a Supero-Bilateral Enlarged Dermal (SBED) pedicle to avoid this graft.

Materials / method: between January 2002 and January 2021, 104 patients with a sternal notch-to-nipple distance ≥ 40 cm underwent surgery using this superior pedicle technique with a wider base for the nipple-bearing flap harboring, partially or totally, the two (internal and external) vertical branches.

Results: Mean jugular notch to nipple distance was 43.7 cm [40-52], mean breast ptosis was 14 cm [11-22], and mean brassiere size was 42DD [40D-48DD+]. Mean weight reduction was 1395 g/breast. Areolar necrosis never occurred, 14 patients presented early minor scar disunion with prolonged healing time and 8 patients experienced postoperative inflammation with lymphorrhea. The result was considered highly or very highly satisfactory by 94 percent of the patients.

Conclusion: Mammaplasty with Superobilateral Enlarged Dermal Pedicle is an efficient and safe technique, which avoids free nipple graft technique in gigantomastia with extreme ptosis.

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