Surgical correction of breast deformities following long-lasting complications of polyurethane-covered implants

Breast deformities following long-lasting complications associated with the use of polyurethane prostheses are encountered with increasing frequency in our practice. Patients with this problem often feel frustrated after a long period of unsuccessful treatment and multiple operations. The anatomopathological bases of the deformity in such patients can be summarized as follows: volumetric mammary defect, soft tissue deficiency, and distortion and fibrosis of residual breast tissues. The reconstructive procedure should provide adequate aesthetic results with permanent or long-lasting symmetry, possibly in a single operative stage. The procedures employed in 12 patients are reviewed, and 3 representative cases are described in detail. The best aesthetic results in difficult cases have been achieved with either a latissimus dorsi muscular flap raised through minimal posterior incisions and transposed anteriorly to cover a permanent, expandable implant, or a suitably tailored, partly deepithelialized transverse rectus abdominis musculocutaneous flap.