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The Core Gel Study is designed to demonstrate safety and effectiveness of Mentor's Round Low-Bleed Silicone Gel-filled Mammary Prostheses in women who are undergoing primary augmentation, primary reconstruction, or revision. Safety information on the rate of capsular contracture, rupture, and infection will be collected, and used to help determine device safety.
Approximately 1000 patients at centers across the United States will be enrolled in this research study. These patients will be implanted with silicone breast prostheses and monitored for 10 years to collect information on risks associated with the implant surgery as well as changes in the way these patients feel about themselves.
Silicone gel-filled breast implants were introduced in the early sixties and were in wide-scale distribution by the time the Medical Device Amendments to the Food Drug and Cosmetic Act was passed in 1976. In 1983, gel-filled breast implants were designated as Class III devices requiring premarket approval. In May 1990, the Food and Drug Administration (FDA) published a proposed request (515(b)) for Premarket Approval Applications (PMA) and in April 1991 published the final request. This final publication put manufacturers of gel-filled breast implants on notice that for continued marketing of gel-filled breast implants, a PMA was due to FDA in 90 days from the final publication date.
A premarket approval (PMA) for the Mentor gel-filled breast implants was filed with the FDA in July 1991. At the FDA General and Plastic Surgery Advisory Committee meeting in November 1991, the committee recommended the submission of additional information to establish the safety and effectiveness of gel-filled breast implants.
In January 1992, the FDA Commissioner announced a voluntary moratorium of the sale of gel-filled breast implants to allow the advisory panel time to assess additional information. In April 1992, the moratorium was lifted but only for reconstruction and revision patients. Every patient implanted had to be part of an adjunct study, and had to be offered participation in a registry of gel-filled breast implant patients. In order to be implanted with gel-filled implants for augmentation, women had to be enrolled in a core clinical study.
The objective of this study is to determine the safety and effectiveness of the smooth and textured surface Mentor Round Low-Bleed Silicone Gel-filled Mammary Prostheses in women who are undergoing primary breast augmentation, primary breast reconstruction or revision.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Primary Augmentation | Other | The Augmentation cohort will include patients who have post-lactational mammary involution or wish general breast enlargement. |
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| Primary Reconstruction | Other | The Reconstruction cohort will include patients with loss of breast due to mastectomy or with deformities secondary to disease, malignancy, trauma, and congenital deformity. Congenital deformities will include deformities of the breast itself as well as skeletal abnormalities reflected in breast deformity or asymmetry. |
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| Revison Augmentation | Other | Patients in this cohort will have had previous breast augmentation with silicone or saline filled implants and are having a revision surgery to correct or improve the result of any previous breast augmentation surgery. |
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| Revision Reconstruction | Other | Patients in this cohort will have had previous breast reconstruction with silicone or saline filled implants and are having a revision surgery to correct or improve the result of any previous breast reconstruction surgery. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mentor Round Low Bleed Gel-filled Mammary Protheses, both Siltex and Smooth Surface | Device | Two types of Mentor Round Low-Bleed Silicone Gel-filled Mammary Prostheses will be used in the study: the Siltex textured surface device and the smooth surface device. Each implant is a silicone elastomer (rubber) mammary device that is supplied individually packaged in a doubled wrapped packaging system, sterile, and non-pyrogenic (does not cause fever). Each device consists of a silicone shell encasing a silicone gel filler material with a patch on the posterior side of the device. The basic smooth device shell consists of a silicone layer sandwiched in between two other silicone layers. This construction acts as a barrier to slow the diffusion of (spread) any gel filler materials through the shell. The Siltex textured shell consists of a smooth shell to which is bonded an additional layer of silicone with a textured pattern imprinted into its surface. The Siltex shell is intended to prevent tissue ingrowth. The implants will be available in sizes 100cc through 800ccs. |
| Measure | Description | Time Frame |
|---|---|---|
| 10-Year Kaplan-Meier Estimated Cumulative Incidence Rate of Occurrence of Any Reoperation | Time of occurrence calculated as the number of days from the date of the implant procedure to the onset date of the event. Patients were censored as of the date of their last office visit, the 120 month time point, or the date of explantation of all initial study devices, whichever was earliest. | 10 years |
| Overall Mean Change in Circumferential Chest Size | Change in Chest Size was calculated by subtracting the chest circumference prior to surgery from the chest circumference measured at the end of the study | Change from baseline to 10 years post-baseline |
| 10-Year Kaplan-Meier Estimated Cumulative Incidence Rate of Occurrence of Baker III, IV Capsular Contracture | Baker III was identified as "firm with visible distortion" and Baker IV was identified as "obvious spherical distortion". Time of occurrence calculated as the number of days from the date of the implant procedure to the onset date of the event. Patients were censored as of the date of their last office visit, the 120 month time point, or the date of explantation of all initial study devices, whichever was earliest. | 10 Years |
| 10-Year Kaplan-Meier Estimated Cumulative Incidence Rate of Occurrence of Infection | Time of occurrence calculated as the number of days from the date of the implant procedure to the onset date of the event. Patients were censored as of the date of their last office visit, the 120 month time point, or the date of explantation of all initial study devices, whichever was earliest. | 10 Years |
| 10-Year Kaplan-Meier Estimated Cumulative Incidence Rate of Occurrence of Explantation With or Without Replacement | Time of occurrence calculated as the number of days from the date of the implant procedure to the onset date of the event. Patients were censored as of the date of their last office visit, the 120 month time point, or the date of explantation of all initial study devices, whichever was earliest. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mentor Worldwide, LLC | Santa Barbara | California | 93111 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33620918 | Derived | Caplin DA, Calobrace MB, Wixtrom RN, Estes MM, Canady JW. MemoryGel Breast Implants: Final Safety and Efficacy Results after 10 Years of Follow-Up. Plast Reconstr Surg. 2021 Mar 1;147(3):556-566. doi: 10.1097/PRS.0000000000007635. | |
| 25158767 | Derived | Caplin DA. Indications for the use of MemoryShape breast implants in aesthetic and reconstructive breast surgery: long-term clinical outcomes of shaped versus round silicone breast implants. Plast Reconstr Surg. 2014 Sep;134(3 Suppl):27S-37S. doi: 10.1097/PRS.0000000000000609. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Primary Augmentation | The Augmentation cohort will include patients who have post-lactational mammary involution or wish general breast enlargement. |
| FG001 | Primary Reconstruction |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| 10 Years |
The Reconstruction cohort will include patients with loss of breast due to mastectomy or with deformities secondary to disease, malignancy, trauma, and congenital deformity.
Congenital deformities will include deformities of the breast itself as well as skeletal abnormalities reflected in breast deformity or asymmetry.
Asymmetry is one or more of the following conditions:
| FG002 | Revision Augmentation | Patients in this cohort will have had previous breast augmentation or reconstruction with silicone or saline filled implants. |
| FG003 | Revision Reconstruction | Patients in this cohort will have had previous breast reconstruction with silicone or saline filled implants and are having a revision surgery to correct or improve the result of any previous breast reconstruction surgery. |
| COMPLETED |
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| NOT COMPLETED |
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All enrolled subjects are included
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| ID | Title | Description |
|---|---|---|
| BG000 | Primary Augmentation | The Augmentation cohort will include patients who have post-lactational mammary involution or wish general breast enlargement. |
| BG001 | Primary Reconstruction | The Reconstruction cohort will include patients with loss of breast due to mastectomy or with deformities secondary to disease, malignancy, trauma, and congenital deformity. Congenital deformities will include deformities of the breast itself as well as skeletal abnormalities reflected in breast deformity or asymmetry. Asymmetry is one or more of the following conditions:
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| BG002 | Revision Augmentation | Patients in this cohort will have had previous breast augmentation or reconstruction with silicone or saline filled implants. |
| BG003 | Revision Reconstruction | Patients in this cohort will have had previous breast reconstruction with silicone or saline filled implants and are having a revision surgery to correct or improve the result of any previous breast reconstruction surgery. |
| BG004 | Total | Total of all reporting groups |
| Units | Counts |
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| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
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| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||
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| Primary | 10-Year Kaplan-Meier Estimated Cumulative Incidence Rate of Occurrence of Any Reoperation | Time of occurrence calculated as the number of days from the date of the implant procedure to the onset date of the event. Patients were censored as of the date of their last office visit, the 120 month time point, or the date of explantation of all initial study devices, whichever was earliest. | All enrolled subjects are included | Posted | Number | 95% Confidence Interval | percentage of subjects | 10 years |
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| Primary | Overall Mean Change in Circumferential Chest Size | Change in Chest Size was calculated by subtracting the chest circumference prior to surgery from the chest circumference measured at the end of the study | All enrolled subjects | Posted | Mean | Standard Deviation | centimeters | Change from baseline to 10 years post-baseline |
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| Primary | 10-Year Kaplan-Meier Estimated Cumulative Incidence Rate of Occurrence of Baker III, IV Capsular Contracture | Baker III was identified as "firm with visible distortion" and Baker IV was identified as "obvious spherical distortion". Time of occurrence calculated as the number of days from the date of the implant procedure to the onset date of the event. Patients were censored as of the date of their last office visit, the 120 month time point, or the date of explantation of all initial study devices, whichever was earliest. | All enrolled subjects | Posted | Number | 95% Confidence Interval | percentage of subjects | 10 Years |
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| Primary | 10-Year Kaplan-Meier Estimated Cumulative Incidence Rate of Occurrence of Infection | Time of occurrence calculated as the number of days from the date of the implant procedure to the onset date of the event. Patients were censored as of the date of their last office visit, the 120 month time point, or the date of explantation of all initial study devices, whichever was earliest. | All enrolled subjects | Posted | Number | 95% Confidence Interval | percentage of subjects | 10 Years |
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| Primary | 10-Year Kaplan-Meier Estimated Cumulative Incidence Rate of Occurrence of Explantation With or Without Replacement | Time of occurrence calculated as the number of days from the date of the implant procedure to the onset date of the event. Patients were censored as of the date of their last office visit, the 120 month time point, or the date of explantation of all initial study devices, whichever was earliest. | All enrolled subjects | Posted | Number | 95% Confidence Interval | percentage of subjects | 10 Years |
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| Post-Hoc | 10-Year Kaplan-Meier Estimated Cumulative Incidence Rate of Occurrence of Complications | The safety analyses were conducted in accordance with the FDA November 17, 2006 "Guidance for Industry and FDA Staff - Saline, Silicone Gel, and Alternative Breast Implants." The study investigator assessed any complications durign study follow-up visits in alignment with this guidance. Time of occurrence was calculated as the number of days from the date of the implant procedure to the onset date of the event. Patients were censored as of the date of their last office visit, the 120 month time point, or the date of explantation of all initial study devices, whichever was earliest. Complications with an incidence > 5.0% are reported. | All Enrolled Subjects | Posted | Number | 95% Confidence Interval | percentage of subjects | 10 years |
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Baseline to 10 Years.
Adverse events were not coded according to the MedDRA dictionary, rather they were collected as Complications in alignment with the 2006 FDA Guidance. Safety endpoints are summarized under Primary, Secondary, and Post-Hoc Outcome Measures. All complications with a frequency above 5% are reported in the Outcome Measures section.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Primary Augmentation | The Augmentation cohort will include patients who have post-lactational mammary involution or wish general breast enlargement. | 0 | 552 | 0 | 552 | ||
| EG001 | Primary Reconstruction | The Reconstruction cohort will include patients with loss of breast due to mastectomy or with deformities secondary to disease, malignancy, trauma, and congenital deformity. Congenital deformities will include deformities of the breast itself as well as skeletal abnormalities reflected in breast deformity or asymmetry. Asymmetry is one or more of the following conditions:
| 0 | 251 | 0 | 251 | ||
| EG002 | Revison Augmentation | Patients in this cohort will have had previous breast augmentation or reconstruction with silicone or saline filled implants. | 0 | 145 | 0 | 145 | ||
| EG003 | Revision Reconstruction | Patients in this cohort will have had previous breast reconstruction with silicone or saline filled implants and are having a revision surgery to correct or improve the result of any previous breast reconstruction surgery. | 0 | 60 | 0 | 60 |
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Adverse events were not coded according to the MedDRA dictionary, rather they were collected as Complications in alignment with the 2006 FDA Guidance for Industry and FDA Staff - Saline, Silicone Gel, and Alternative Breast Implants.
Sponsor acknowledges that the Investigator and his/her collaborators shall be free to publish the background, methods and results of their own research without restraint. Prior review of any proposed manuscript or abstract will be provided to Sponsor to prevent premature disclosure of trade secrets or proprietary information. The Investigator acknowledges that the Sponsor reserves the right to publish and present the overall study results, including assigning authorship.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Michael L. Schwiers | Ethicon Endo-Surgery | 513-337-1172 | mschwier@its.jnj.com |
| Between 18 and 65 years |
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| >=65 years |
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| Male |
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Patients in this cohort will have had previous breast reconstruction with silicone or saline filled implants and are having a revision surgery to correct or improve the result of any previous breast reconstruction surgery. |
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| OG003 | Revision Reconstruction | Patients in this cohort will have had previous breast reconstruction with silicone or saline filled implants and are having a revision surgery to correct or improve the result of any previous breast reconstruction surgery. |
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| OG003 | Revision Reconstruction | Patients in this cohort will have had previous breast reconstruction with silicone or saline filled implants and are having a revision surgery to correct or improve the result of any previous breast reconstruction surgery. |
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| OG003 | Revision Reconstruction | Patients in this cohort will have had previous breast reconstruction with silicone or saline filled implants and are having a revision surgery to correct or improve the result of any previous breast reconstruction surgery. |
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| OG002 |
| Revison Augmentation |
Patients in this cohort will have had previous breast augmentation or reconstruction with silicone or saline filled implants. |
| OG003 | Revision Reconstruction | Patients in this cohort will have had previous breast reconstruction with silicone or saline filled implants and are having a revision surgery to correct or improve the result of any previous breast reconstruction surgery. |
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