Cap contracture sil vs. saline

[runnergirl29]

Hi Dr Kearney,
Could you please help me understand the likelikhood of cc (percentage) ?

Is it higher for silicone than for saline ? If so by how much?
What is your typical rate of CC in your practice for silicone ? Saline?

My PS office nurse states the risk for cc is about 5% for both sils and saline, and that there is NO difference in cc rate between sil and saline.

Is this true ? I've read that silicone has a much higher rate of cc - like 15%.
Is that true or did I misunderstand?

I also asked the PS his rate of cc and he said he doesn't keep statistics.

Don't most PS want to know their complication rate ? I realize that their patient's behavior (and whether the patients follow all of their instructions) is outside of their control, and they may not want to be responsible for complications when the patient isn't compliant with their instructions. I completely understand that.

But I felt that he didn't want to answer the question.
Do you typically directly answer this question ?

I also asked his nurse if there are certain precautions he takes during surgery to minimize the risks of CC, and she said other than being very careful to cauterize bleeding, most of the healing process is up to the patient....no lifting heavy things for 4-6 wks, massage for 5 months.

What are your thoughts about the bleeding being the main surgical technique to prevent CC ? I had understood many PS wash the pocket w/antibiotics before the implant is placed. Is that true or no ? I had also read about the "No Touch" technique...no cotton lap pads used, changing gloves, etc...is that being used by PS much ?

Thanks for all of your expertise in advance !

[Dr. Kearney]

Could you please help me understand the likelikhood of cc (percentage) ?

Is it higher for silicone than for saline ? If so by how much?
Saline 2%, Silicone 12% to 15%
What is your typical rate of CC in your practice for silicone ? Saline?
Saline <1%, Silicone 3%

My PS office nurse states the risk for cc is about 5% for both sils and saline, and that there is NO difference in cc rate between sil and saline.
That is incorrect - ask the PS

Is this true ? I've read that silicone has a much higher rate of cc - like 15%.
Is that true or did I misunderstand?
see above

I also asked the PS his rate of cc and he said he doesn't keep statistics.
Find a different PS unless you really like him/her

Don't most PS want to know their complication rate ? I realize that their patient's behavior (and whether the patients follow all of their instructions) is outside of their control, and they may not want to be responsible for complications when the patient isn't compliant with their instructions. I completely understand that.
Most PS don't keep statistics but have a pretty good idea about what their complication rates are.

But I felt that he didn't want to answer the question. Find another PS
Do you typically directly answer this question ? Yes

I also asked his nurse if there are certain precautions he takes during surgery to minimize the risks of CC, and she said other than being very careful to cauterize bleeding, most of the healing process is up to the patient....no lifting heavy things for 4-6 wks, massage for 5 months.

??

What are your thoughts about the bleeding being the main surgical technique to prevent CC ?
Only a small incidence I had understood many PS wash the pocket w/antibiotics before the implant is placed.

Great idea! Is that true or no ?

I had also read about the "No Touch" technique...no cotton lap pads used, changing gloves, etc...is that being used by PS much ? I don't think that matters too much. I change gloves if I feel they may have been contaminated but otherwise I use the same pair of gloves the entire case.

Dr. Kearney

[runnergirl29]

Dr Kearney,
Thank you for answering all of my questions...I appreciate your expertise and input !