PubMed · 8604821
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I J Bleiweiss, M J Klein, M Copeland. 1996. Breast prosthesis reaction.. https://doi.org/10.1097/00000478-199604000-00017
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We show that an unmodified, commercially available high-field (17.61T) NMR spectrometer using the DEPT pulse sequence is capable of detecting silicon-containing species down to concentrations of 150 ng/mL (150 ppb) per spin site. This is in the range given for the concentration of silicon in the blood of silicone breast implant recipients, as determined by ICP analysis, and demonstrates that, contrary to the view expressed in the literature, in theory 29Si NMR may be sufficiently sensitive to be of use in determining the nature of the silicon-containing species present. A summary of the factors affecting the detection limits in NMR spectroscopy is given.
In 1996 the authors reported their experience with 92 consecutive patients undergoing traditional (nonendoscopic) transaxillary submuscular breast augmentation. They reported a capsular contraction rate of 1.1% using textured saline implants, as well as an implant malposition rate of 8.6%. At that time they hypothesized that "the endoscope will lessen the rate of implant malposition." To clarify the role of implant texture and to justify the use of endoscopic techniques in transaxillary submuscular breast augmentation, the authors have studied an additional 58 consecutive patients with two significant changes. First, the endoscope was used to dissect the implant pocket in each patient. Second, smooth-wall implants were substituted for the previously used textured implants. Their rate of implant malposition dropped significantly, from 8.6% to 2.0% (p = 0.10), and their capsular contraction rate remained low, at 2.0% (p = 0.63). They conclude that direct endoscopic control improves implant positioning in the transaxillary submuscular operation, and implant texture does not improve capsular contraction rates when the prosthesis is placed in the submuscular position.