To the Editor.—Kissin and Kark1 have stated that the valved, saline-inflatable breast prosthesis (Varifil) has an "unblemished record" and does not deflate. However, they contradicted this statement by reporting their own experience wherein there was a deflation rate in such an implant of 16.5% during a 35-month period. Although the overall deflation rate with this particular implant might be significantly lower in a large series, the deflation rate described by the authors is purely unacceptable.
It is interesting to note that this implant is made of a platinum-cured silicone. All inflatable implants with a platinum-cured silicone shell are no longer available, probably because the platinum-cured elastomer shells such as the Varifil implant are much more susceptible to the development of pinhole leaks due to friction points where the two walls of the implant rub together. This has been termed fold flaw failure. In contrast, implant shells made of
I. KELMAN COHEN. Leakage of Breast Prostheses. Arch Surg. 1984;119(5):615. doi:10.1001/archsurg.1984.01390170109021