Long-term use of polyurethane breast prostheses: a 14-year experience

Area of Science:

• Plastic Surgery
• Biomaterials Science
• Regenerative Medicine

Background:

• Capsular contracture is a common complication following breast implant surgery.
• The surface texture of breast implants influences fibroblast behavior and subsequent capsule formation.
• Polyurethane-coated implants offer a theoretical advantage in reducing capsular contracture.

Purpose of the Study:

• To evaluate the long-term efficacy and complication rates of polyurethane-covered breast implants.
• To compare the incidence of capsular contracture between polyurethane and smooth implants.
• To investigate the mechanism by which polyurethane coatings may prevent contracture.

Main Methods:

• A retrospective study analyzing 220 polyurethane implants in 130 patients over 14 years.
• Inclusion criteria: breast reconstruction (post-mastectomy or augmentation) and augmentation mammaplasty.
• Data collection on capsular contracture, infection, extrusion, and granuloma formation.

Main Results:

• Overall capsular contracture rate was 13% (30/220 implants) over a mean follow-up of 6.3 years.
• Contracture rates varied by indication: 22% post-mastectomy, 2.3% post-cancer ablation, and 15% for augmentation.
• Early polyurethane implants showed granulomas due to material shedding; current implants did not.

Conclusions:

• Polyurethane-covered implants demonstrate a reduced rate of capsular contracture compared to smooth implants.
• Fibroblast proliferation into the polyurethane matrix may counterbalance contracture forces.
• Current polyurethane implants are associated with minimal complications, including absence of granulomas.