Preliminary report on the use of the Spectra™ implant for the correction of hypoplastic breasts with small-volume asymmetry.

[BACKGROUND] Small-volume breast asymmetry is a challenging problem. In 2008, an intra-operative volume-adjustable breast implant, consisting of a round textured implant with an outer chamber filled with cohesive silicone gel and inner chamber filled with varying amounts of saline solution was marketed in Europe. We describe our experience in the correction of hypoplastic breasts with small-volume asymmetry using this device.

[METHODS] From May 2008 on, female patients presenting small-volume breast asymmetry were enrolled in the study. Standard pictures were taken before surgery and during follow-up visits over 1 year; standardised objective measurements of breast and chest were also taken. Statistical significance of value variation was assessed by Wilcoxon's rank sum test. A Visual Analogue Scale (VAS) was used to evaluate patients' and external physicians' judgement of breast symmetry achievement at the end of follow-up. The development of capsular contracture was assessed by measuring mammary compliance.

[RESULTS] A total of 38 females were treated. The implant pocket was subglandular in 14 cases, subpectoral in 14 and dual plane in 10. The adjustable implant was positioned in the smaller breast. A textured round implant, whose diameter was the same as the adjustable one, was positioned in the contralateral breast. Thirty-five patients were fully satisfied; three were partially satisfied. Good aesthetic and functional breast symmetry results were achieved in all patients, as demonstrated by the objective measurement statistical analysis. We observed one case of delayed wound healing, one of bleeding and one of seroma, with no major late complications. Baker's classification grade III capsular contracture was detected in one patient. Both implants maintained their initial volume.

[CONCLUSIONS] The possibility of intra-operatively modifying implant volume according to breast volume differences provides a reliable corrective option for hypoplastic breasts with small-volume asymmetry. Although these results are encouraging, a longer follow-up is required to evaluate implant ageing and long-term outcome.