CC BY 4.0 · Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2025; 40: s00451809393
DOI: 10.1055/s-0045-1809393
Artigo Original

Avaliação da ruptura assintomática de implantes mamários preenchidos com gel de silicone Silimed

Article in several languages: português | English
1   Especialidade de Cirurgia Plástica, Clínica Particular, Rio de Janeiro, RJ, Brasil
› Author Affiliations

Suporte Financeiro

A autora declara que este estudo recebeu suporte financeiro da Silimed.


Ensaio Clínico

NCT02206282.


Resumo

Introdução

O aumento mamário é uma cirurgia estética praticada desde 1895, e que ganhou popularidade na década de 1960 com o surgimento dos implantes de silicone. Embora seja um procedimento comum, podem ocorrer complicações, como a ruptura dos implantes. A ruptura “silenciosa” é especialmente preocupante, pois não apresenta sintomas e requer monitoramento cuidadoso. A United States Food and Drug Administration (FDA) indica os exames de ultrassonografia (USG) ou ressonância magnética (RM) para identificar a ruptura silenciosa.

Objetivo

Avaliar a taxa de rupturas assintomáticas em pacientes com implantes mamários de envelope externo lisos e texturizados da marca Silimed (Silimed Indústria de Implantes Ltda.) por meio de RM.

Materiais e Métodos

Foram selecionados 97 cirurgiões de diversas cidades brasileiras com prontuários de pacientes que utilizavam implantes Silimed. Foram excluídas pacientes com implantes de outros fabricantes, gestantes, e aquelas com contraindicações para a RM. As pacientes selecionadas realizaram exames clínicos e RM, e as imagens foram analisadas por radiologistas independentes. Suspeitas de ruptura foram confirmadas cirurgicamente.

Resultados

Entre as 161 pacientes avaliadas, 2 (0,63%) apresentaram suspeita de ruptura confirmada cirurgicamente, ambas com 9 anos de implantação: uma com implante liso e outra, com texturizado. A maioria dos implantes foi considerada íntegra: 99,67% dos texturizados e 95,24% dos lisos.

Conclusão

Este estudo contribui para o conhecimento científico sobre rupturas de implantes mamários, e sugere que os implantes Silimed são seguros. A taxa de ruptura assintomática em implantes com 5 a 10 anos de implantação foi baixa.

Número do Comitê de Ética

174.


Estudo realizado no Hospital Pró-Cardíaco, Rio de Janeiro, RJ. Brasil.




Publication History

Received: 10 November 2023

Accepted: 24 March 2025

Article published online:
20 June 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil

Bibliographical Record
Wanda Elizabeth Massiere-y-Corrêa. Avaliação da ruptura assintomática de implantes mamários preenchidos com gel de silicone Silimed. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2025; 40: s00451809393.
DOI: 10.1055/s-0045-1809393
 
  • Referências

  • 1 Goldwyn RM. Vincenz Czerny and the beginnings of breast reconstruction. Plast Reconstr Surg 1978; 61 (05) 673-681
  • 2 Cronin TD, Gerow FJ. Augmentation mammaplasty: a new “natural feel” prosthesis. In: Transactions of the Third International Congress of Plastic Surgery. Amsterdam: Excerpta Medica Foundation; 1964: 41-49
  • 3 Pirjavec Mahić A, Grebić D, Čargonja P, Kustić D. Silicone Gel Breast Implants: Past, Present, and Future. Acta Med Hist Adriat 2020; 18 (01) 165-176
  • 4 Yoon WJ. Endoscopic Transaxillary Augmentation Mammoplasty. New York: Springer; 2019
  • 5 Dempsey WC, Latham WD. Subpectoral implants in augmentation mammaplasty. Plast Reconstr Surg 1968; 42 (06) 515-521
  • 6 Griffiths CO. The submuscular implant in augmentation mammaplasty. In: Translations of the Fourth International Congress of Plastic Surgery. Amsterdam: Excerpta Medica Foundation; 1967: 1009-1015
  • 7 Regnault P. Partially Submuscular Breast Augmentation. Plast Reconstr Surg 1977; 59 (01) 72-76
  • 8 Hoehler H. Breast augmentation: the axillary approach. Br J Plast Surg 1973; 26 (04) 373-376
  • 9 Höhler H. Further progress in the axillary approach in augmentation mammaplasty: Prevention of incapsulation. Aesthetic Plast Surg 1976; 1 (01) 107-113
  • 10 Eiseman G. Augmentation mammaplasty by the trans-axillary approach. Plast Reconstr Surg 1974; 54 (02) 229-232
  • 11 Ho LCY. Endoscopic assisted transaxillary augmentation mammaplasty. Br J Plast Surg 1993; 46 (04) 332-336
  • 12 Price CI, Eaves III FF, Nahai F, Jones G, Bostwick III J. Endoscopic transaxillary subpectoral breast augmentation. Plast Reconstr Surg 1994; 94 (05) 612-619
  • 13 Di Pompeo FS, Paolini G, Firmani G, Sorotos M. History of breast implants: Back to the future. JPRAS Open 2022; 32: 166-177
  • 14 Mccarthy C. Too Young to Decide? The FDA's Role in Regulating Breast Augmentation in Adolescents. Women Leading Change 2019; 4 (02) 67-81
  • 15 Perry D, Frame J. The history and development of breast implants. Annals of the Royal College of Surgeons of England 2020; 102 (07) 478-482
  • 16 International Society of Aesthetic Plastic Surgery. ISAPS International Survey on Aesthetic/Cosmetic Procedures Performed in 2023. ISAPS; 2024. . Available from: https://www.isaps.org/media/rxnfqibn/isaps-global-survey_2023.pdf
  • 17 Burciaga FJdlR, Rivas HAS, Preza LGG, Cervantes AFV, Gómez LDN. Breast Implant Rupture: Causes, Diagnosis and Treatment. Int J Med Sci Public Health 2023; 3 (05) 857-860
  • 18 Lake E, Ahmad S, Dobrashian R. The sonographic appearances of breast implant rupture. Clinical Radiology 2013; 68 (08) 851-858
  • 19 Salzman MJ. Silent Rupture of Silicone Gel Breast Implants: High-Resolution Ultrasound Scans and Surveys of 584 Women. Plast Reconstr Surg 2022; 149 (01) 7-14
  • 20 Ayyala HS, Afifi T, McCarthy C, Cordeiro P. To screen or not to screen: Evaluation of Magnetic Resonance Imaging Surveillance to assess silicone breast implant integrity. Plast Reconstr Surg Glob Open 2022; 10 (4S): 15-16
  • 21 Mazzocconi L, De Lorenzi F, Carbonaro R, Lorenzano V, Rotili A, Pesapane F. et al. Non-contrast MRI and post-mastectomy silicone breast implant rupture: preventing false positive diagnoses. Eur J Cancer Prev 2024; 33 (06) 525-532
  • 22 Goldammer F, Pinsolle V, Dissaux C, Pélissier P. Accuracy of mammography, sonography and magnetic resonance imaging for detecting silicone breast implant ruptures: A retrospective observational study of 367 cases. Ann Chir Plast Esthet 2021; 66 (01) 25-41
  • 23 Food and Drug Administration (FDA). Breast Implants - Certain Labeling Recommendations to Improve Patient Communication. Guidance for Industry and Food and Drug Administration Staff. Rockville, MD: FDA; 2020. . Available from: https://www.fda.gov/media/131885/download
  • 24 Hölmich LR, Friis S, Fryzek JP, Vejborg IM, Conrad C, Sletting S. et al. Incidence of silicone breast implant rupture. Arch Surg 2003; 138 (07) 801-806
  • 25 Pitanguy I, Amorim NFGd, Ferreira AV, Berger R. Análise das trocas de implantes mamários nos últimos cinco anos na Clínica Ivo Pitanguy. Rev Bras Cir Plást 2010; 25 (04) 668-674
  • 26 Scaranelo AM, Marques AF, Smialowski EB, Lederman HM. Evaluation of the rupture of silicone breast implants by mammography, ultrasonography and magnetic resonance imaging in asymptomatic patients: correlation with surgical findings. Sao Paulo Med J 2004; 122 (02) 41-47
  • 27 Stevens WG, Calobrace MB, Alizadeh K, Zeidler KR, Harrington JL, D'Incelli RC. Ten-year core study data for sientra's food and drug Administration–Approved round and shaped breast implants with cohesive silicone gel. Plast Reconstr Surg 2018; 141 (4S Sientra Shaped and Round Cohesive Gel Implants): 7S-19S
  • 28 Spear SL, Murphy DK. Allergan Silicone Breast Implant U.S. Core Clinical Study Group. Natrelle round silicone breast implants: Core Study results at 10 years. Plast Reconstr Surg 2014; 133 (06) 1354-1361
  • 29 Caplin DA, Calobrace MB, Wixtrom RN, Estes MM, Canady JW. MemoryGel Breast Implants: Final Safety and Efficacy Results after 10 Years of Follow-Up. Plast Reconstr Surg 2021; 147 (03) 556-566
  • 30 Fritsch H, Celik M, Warm M, Thangarajah F, Vogel-Minea C, Malter W. et al. Sonographic Assessment of Breast Implants Using Strain Elastography and Shear Wave Elastography in an Animal Model. Anticancer Res 2024; 44 (02) 497-501
  • 31 Di Benedetto G, Cecchini S, Grassetti L, Baldassarre S, Valeri G, Leva L. et al. Comparative Study of Breast Implant Rupture Using Mammography, Sonography, and Magnetic Resonance Imaging: Correlation with Surgical Findings. Breast J 2008; 14 (06) 532-537
  • 32 Maijers MC, Niessen FB, Veldhuizen JFH, Ritt MJPF, Manoliu RA. MRI screening for silicone breast implant rupture: accuracy, inter- and intraobserver variability using explantation results as reference standard. Eur Radiol 2014; 24 (06) 1167-1175
  • 33 Lotan AM, Retchkiman M, Tuchman I, Binenboym R, Gronovich Y. Analysis of 109 Consecutive Explanted Breast Implants: Correlation Between Suspected Implant Rupture and Surgical Findings. Aesthetic Plast Surg 2016; 40 (05) 739-744
  • 34 Haws MJ, Alizadeh K, Kaufman DL. Sientra primary and revision augmentation rupture trending and analysis with magnetic resonance imaging. Aesthet Surg J 2015; 35 (Suppl. 01) S33-S42
  • 35 Paolini G, Firmani G, Briganti F, Macino M, Nigrelli S, Sorotos M, Di Pompeo FS. Assessment of Risk Factors for Rupture in Breast Reconstruction Patients with Macrotextured Breast Implants. Aesthetic Plast Surg 2023; 47 (02) 517-530
  • 36 Larsen A, Bak EEF, Hart LB, Timmermann AM, Ørholt M, Weltz TK. et al. Silicone Leakage from Breast Implants Is Determined by Silicone Cohesiveness: A Histologic Study of 493 Patients. Plast Reconstr Surg 2024; 154 (06) 1159-1171
  • 37 Kinney BM, Jeffers LLC, Ratliff GE, Carlisle DA. Silicone gel breast implants: science and testing. Plast Reconstr Surg 2014; 134 (1, Suppl) 47S-56S
  • 38 Lindenblatt N, El-Rabadi K, Helbich TH, Czembirek H, Deutinger M, Benditte-Klepetko H. Correlation between MRI results and intraoperative findings in patients with silicone breast implants. Int J Womens Health 2014; 6: 703-709
  • 39 Kim HB, Han HH, Eom JS. Magnetic Resonance Imaging Surveillance Study of Silicone Implant-based Breast Reconstruction: A Retrospective Observational Study. Plast Reconstr Surg Glob Open 2023; 11 (06) e5031
  • 40 Hillard C, Fowler JD, Barta R, Cunningham B. Silicone breast implant rupture: a review. Gland Surg 2017; 6 (02) 163-168
  • 41 Fleury EdFC. Breast silicone implants' pericapsular impairment: current underdiagnosed status. Front Surg 2023; 10: 1249078