Filling of adjustable breast implants beyond the manufacturer's recommended fill volume.

[BACKGROUND] Adjustable breast implants are widely used for both reconstructive and cosmetic breast surgery. They provide unique postoperative versatility and allow for more effective management of numerous conditions that would otherwise require surgical intervention. Findings have shown that in a clinical setting, it often is necessary to overexpand saline implants beyond the manufacturer's recommended fill volumes for positive results and optimal patient satisfaction. The authors investigated their breast-augmentation patients, comparing implants expanded beyond the manufacturer's fill volume with implants that remained within the recommended parameters.

[METHODS] A total of 138 patients (270 implants) undergoing breast augmentation mammoplasty with Smooth Round Spectrum implants were evaluated postoperatively. To determine the effects of overexpansion, the incidence of leakage was assessed as well as the possibility of increased firmness. Patients completed a satisfaction questionnaire.

[RESULTS] The findings showed no evidence of increased leakage with implants expanded beyond recommended fill volumes, and 97% of the patients reported a perfect score for satisfaction ratings. Of the 270 implants evaluated in the study, only 7 were given a less than perfect score.

[CONCLUSIONS] By exceeding the recommended fill volume, the authors were able to use the implant to its maximal potential, with increased patient satisfaction. The authors were able to correct problems and avoid complications that could not have been resolved without deviating from the manufacturer's recommended fill volumes. Nonvalidated restrictions on fill volumes severely limit the efficacy of adjustable implants.