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Breast augmentation implant surgery is one of the most frequently performed plastic surgery procedures; however, it can be challenging because of its associated complications. METHOD: We conducted a retrospective study of 546 patients operated on in eight years (May 2004 to May 2012). These patients underwent breast augmentation, alone or in association with mastopexy or breast reduction. RESULTS: In this study, 84.8% textured and 15.2% polyurethane prostheses, with 91.7% deployed in the subglandular plane and 8.24% in the submuscular plane, were used. We investigated the occurrence of contracture (3.3%), seroma (2.7%), ptosis (2.7%), and infection (0.6%). Most contractures occurred 5 years after surgery and only in textured prostheses, which had a longer follow-up (4.2 years for textured implants vs. 1.7 years for polyurethane implants). There was a higher frequency of ptosis in textured implants and of infection in polyurethane implants. Only patients with textured prostheses showed contractures in the observed period. Concerning the deployment plane, seroma was more frequently observed in submuscular implants. More complex procedures showed a higher rate of complications. Polyurethane implants were associated with increased infection rates, whereas textured implants resulted in ptosis and seroma; however, there were no differences in contracture rates. All cases of infection occurred in patients who received reduction mammoplasty with polyurethane prostheses and were caused by common germs, with no cases of mycobacterial infection. CONCLUSIONS: Contractures and ptosis uniquely occurred in textured prostheses in the shortest follow-up time. Infection occurred only in polyurethane prostheses. Mastopexies and reduction mammoplasties showed a progressively higher rate of complications. INTRODUCAO: O implante de proteses mamarias e uma das cirurgias mais frequentes e desafiadoras da cirurgia plastica, devido as complicacoes associadas. METODO: Foi realizado um estudo retrospectivo de 546 pacientes operadas em oito anos (maio de 2004 a maio de 2012), sendo estudadas todas as pacientes submetidas a inclusao de proteses mamarias, isoladamente ou associadas a mastopexia ou mamoplastia redutora. RESULTADOS: Foram utilizadas proteses texturizadas em 84,8% e poliuretano, em 15,2%, com plano de implantacao subglandular em 91,7% e submuscular, em 8,24%. Foram estudados: contratura (3,3%), seroma (2,7%), ptose (2,7%) e infeccao (0,6%). A maioria das contraturas surgiu cinco anos apos a cirurgia e apenas nas proteses texturizadas, que tiveram tempo de seguimento maior (4,2 anos, nas proteses texturizadas versus 1,7 ano nas de poliuretano). Houve maior frequencia de ptose nas texturizadas e de infeccao, nas de poliuretano. Somente apresentaram contraturas pacientes com proteses texturizadas no periodo observado. Comparando-se o plano de implantacao, o seroma foi mais frequente nas submusculares. Considerando-se a complexidade do procedimento, houve aumento do indice de complicacoes: nas implantadas com poliuretano, aumentou o indice de infeccao; nas texturizadas, de ptose e seroma, mas nao houve diferencas quanto a contratura. Todos os casos de infeccao ocorreram em mamoplastias redutoras com proteses de poliuretano e foram causados por germes comuns, sem casos de micobacterias. CONCLUSOES: Contraturas e ptose foram exclusivas em proteses texturizadas, no tempo de seguimento mais curto. Infeccao apenas ocorreu em proteses de poliuretano. As mastopexias e mamoplastias redutoras apresentaram um indice progressivamente mais alto de complicacoes.

A report on complications of breast implantation: evaluation of 546 cases in 8 years