<< Back to the abstract archive
Restoring Breast Volume in High BMI Patients: A Single-Center Review of Breast Reconstruction Using Hyperinflated Saline Implants
Milind D. Kachare, MD
Swapnil D. Kachare, MD, MBA
Bradley J Vivace, MD
Omar Elfanagely, MD
Brooke Barrow, MEng
Alyssa M Simpson, MD
Bradon J Wilhelmi, MD
University of Louisville
2022-01-15
Presenter: Mitchell B Peake
Affidavit:
Agree
Director Name: Bradon J. Wilhelmi
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background:
Breast reconstruction in the obese patient is often fraught with poor patient satisfaction due to inadequate volume restoration. The off-label hyperinflation of saline implants is a direct, yet controversial solution to this problem, with limited studies in the literature. We sought to determine the safety and efficacy of this technique for breast reconstruction.
Methods:
A retrospective chart review was performed to identify all patients with a body mass index (BMI) ≥ 30 kg/m2 who underwent breast reconstruction between the years 2013 to 2020 with saline implants filled beyond the manufacturer's maximum recommended volume.
Results:
Twenty-one patients were identified with an average age of 49 years. The mean BMI was 39.5 kg/m2. A total of 42 implants were placed; 34 were 800cc, four were 750cc, and four were 700cc. The average overfill volume was 302cc (138%). Mean follow-up was 65.0 months. One (4.8%) patient with a history of chest wall radiotherapy underwent reoperation for unilateral implant exposure 27 days after the index procedure. No patient sustained spontaneous leak or rupture; one patient had unilateral deflation following emergent central line and pacemaker placement two years after the implant was placed for an unrelated cardiovascular event.
Conclusions:
Hyperinflation of saline implants beyond the maximum recommended volume may be considered for volume replacement in obese patients undergoing implant-based breast reconstruction. This practice is well tolerated, has a complication rate comparable to using implants filled to the recommended volume, and has the potential to restore lost breast volume in the obese patient post-mastectomy.
