In Reply.—We were most interested to read Professor Cohen's comments. We were unable to trace any references in the literature to previous failures of this particular prosthesis, although deflation has been reported in other similar prostheses. We have now used the Varifil prosthesis in a total of 30 patients with a mean follow-up time of 30 months and a minimum follow-up time of 18 months. During this extended period there have been no further instances of either deflation or capsule formation. Thus, the significant complication rate of deflation (13%) must be judged in association with a low rate of capsule formation (13%). The judgment concerning the softer texture of the inflatable prosthesis is a clinical observation that we made when these patients were compared with patients who had silicone gel prostheses. This probably reflects the increased proportion of patients with a Baker grade I result.
We would stress that