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Short-term Outcomes following Breast Reconstruction with the Structured Saline Implant
Susan J. Doh, MD,1 Tomislav Medved, MD,1 Maura Guyler, BA,2 Adam Ghazoul, BS,3 Peter Koltz, MD,4 Joseph S. Khouri, MD1
1. University Hospitals Cleveland Medical Center, Cleveland, OH
2. Case Western Reserve University
2025-01-10
Presenter: Susan J. Doh, MD
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. 100% of the work on this project represents the original work of the resident.
I approve of the inclusion of my electronic signature.
Director Name: John Ammori
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: The internal structure of nested shells in structured saline implants provides many potential benefits in breast reconstruction. Silicone implant complication rates are well known; however, structured saline implant usage is increasing in this population. This study examines the safety and efficacy of the structured saline implant in reconstruction using the largest known series to date.
Methods: A retrospective review of reconstructions with the structured saline implant (2022-2024) was performed across two institutions. Descriptive statistics were used to analyze the cohort.
Results: 224 patients (391 breasts) were included. Median follow up was 271 days (range, 84-623 days). Median age was 49 (range, 23-78). Of 269 breasts, 62 (23%) were primary reconstructions with Direct-to-Implant, and 207 (77%) were revision or second stage reconstructions. Of 391 breasts, Skin-sparing mastectomies (n = 165 [42%]) and prepectoral placement (n = 377 [96%]) were common. Median total implant volume was 505cc (range, 325-795cc). Complications included Baker grade III/IV capsular contracture (n = 7 [1.8%]), wrinkling (n = 12 [3%]), implant exposure (n = 2 [0.5%]), and reoperation (n = 38 [10%]). 15 (4%) implants were removed and replaced, and 6 (1.5%) implants were removed without replacement. Most common reasons for reoperation included asymmetry (n = 13), dissatisfaction with size (n = 6), superior and medial hollowing (n = 6), hematoma (n = 3), and infection (n = 2).
Conclusion: The use of structured saline breast implants in reconstruction has an acceptable complication profile in this population. Further research on long-term outcomes is needed.
