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Comparative experience with smooth and polyurethane breast implants using the Kaplan-Meier method of survival
N Handel1, M J Silverstein, J A Jensen
1Breast Center, Van Nuys, Calif. 91405.
Plastic and Reconstructive Surgery
|September 1, 1991
Summary
Polyurethane-covered breast implants significantly reduce capsular contracture compared to smooth-walled implants. This study utilized survival analysis to demonstrate the lower incidence of this common complication in breast augmentation surgery.
Area of Science:
- Plastic Surgery
- Biomaterials Science
- Medical Statistics
Background:
- Capsular contracture is a frequent complication following breast augmentation with smooth-walled silicone implants, leading to firmness and deformity.
- Previous research suggests polyurethane-covered implants may lower contracture rates, but statistical methods have faced scrutiny.
Purpose of the Study:
- To compare the incidence of capsular contracture between polyurethane-covered and smooth-walled breast implants.
- To evaluate the efficacy of the Kaplan-Meier method for analyzing clinical outcomes in plastic surgery.
Main Methods:
- A retrospective study analyzing data from 427 polyurethane and 439 smooth breast implants used between July 1984 and June 1990.
- Capsular contracture occurrence was monitored and analyzed using the Kaplan-Meier survival analysis method.
- Patient follow-up was incomplete, and contractures occurred at varying intervals, making Kaplan-Meier analysis appropriate.
Main Results:
- The probability of capsular contracture was significantly greater with smooth-walled prostheses compared to polyurethane-covered implants (p < 0.05).
- No significant difference in other complication rates was observed between the two implant types.
- The Kaplan-Meier method proved effective for analyzing clinical data with variable follow-up times.
Conclusions:
- Polyurethane-covered breast implants are associated with a lower rate of capsular contracture.
- The Kaplan-Meier survival analysis is a suitable statistical tool for assessing outcomes in plastic surgery, particularly with incomplete follow-up data.