Mammary augmentation by cohesive silicone gel implants with anatomic shape: technical considerations.

Anatomically formed cohesive silicon gel implants for mammary augmentation or restoration were first introduced in 1993. They have been allowed for use in the most of European countries, but not in the Northern America for the past few years. These implants are appreciated by many patients, but they are still controversial, because the whole concept of treatment is different from the techniques used for implants filled with normal saline or liquid silicone. Cohesive gel implants can give us excellent results, but the margin for mistakes is near zero. Information about the new techniques necessary to use with these implants has so far been scarce. This paper gives detailed description of the preoperative preparations, the operation step-by-step, and the postoperative care for patients with the cohesive gel implants and is based on the four years experience with 440 patients. Our personal technique using the intracutaneous wound closure with totally buried resorbable suture and the implant of new design, with the marking string on the front and fixation plate on the posterior surface, is presented.