BACKGROUND: Saline breast implant rupture remains problematic after implantation. Company reports and previous studies implicate the valve as a common site of implant failure. This study evaluates the rupture rate of the Mentor posterior valve compared with the anterior valve in breast augmentation and reconstruction. METHODS: This is a retrospective analysis of consecutive breast implantations performed between 1992 and 2004 by two surgeons. All but two implants were filled at or above the manufacturer-recommended volume. Data were collected by chart review, telephone survey, and Mentor Corp. reports. Kaplan-Meier and Mantel-Haenszel analyses were used to compare rupture rate and relative risks, respectively. RESULTS: Sufficient data were available for 516 implants in 325 women (average follow-up, 6.04 years). Overall, those implants with posterior valves had a lower rupture rate (0.007 versus 0.022). In the reconstructive cohort, the posterior valve implants had a lower rupture rate (0.011 versus 0.036), and the relative risk of rupture using an anterior valve versus a posterior valve was 3.387 (p = 0.0154). There was no significant difference in rupture rate between valve types in breast augmentation. A multivariate analysis showed that implant texture did not affect rupture rate. CONCLUSIONS: The authors found a statistically significant decrease in implant rupture for Mentor posterior valve implants in the reconstructive cohort and no difference in the augmentation cohort. Thus, the authors conclude that at worst, the posterior valve is not more prone to rupture than the anterior valve model. Furthermore, the authors believe that the postoperative flexibility of the posterior valve implants makes them more useful clinically.
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