Breast thinning and streaking following the use of inflatable implants--a subjective clinical study.

A subjective retrospective analysis of 250 patients was done to better understand a serious long-term complication of inflatable implants. A series of 397 breasts with inflatable prostheses exhibited 32% thinning of the breast tissue. Fifty-six percent of the thinning was found in the first 2 years, and 74% by 3 years. Of those breasts that thinned, 31.5% exhibited the streaking phenomenon. Breasts were divided into categories of bilateral Decadron addition, right-sided addition, and no addition. All groups showed roughly 30% thinning with equal right-sided and left-sided distribution. No treatment is needed for mild thinning (41% of this series), but a change to a gel prosthesis is advocated for more severe cases. Breast thinning following inflatable implants is thought to be related to pressure atrophy, not to the addition of steroids. Generalized tissue malacia has not been seen with the use of gel prostheses. With longer follow-up a higher rate of thinning is anticipated. From this study it is believed the inflatable implant is not the prosthesis of choice, and its use has been discontinued by the author.