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Published on: May 17, 2024
Polyurethane Implants in 2-Stage Breast Reconstruction: 9-Year Clinical Experience
Stefano Pompei1, Floriana Arelli2, Lara Labardi2
1Dr Pompei is Head of the Plastic and Reconstructive Surgery Unit, and Drs Arelli, Labardi, and Marcasciano are Consultant Plastic Surgeons, San Camillo Hospital, Rome, Italy. Dr Evangelidou is a Plastic Surgeon, Emirates Hospital Group Plastic and Reconstructive Surgery Department, Dubai, United Arab Emirates. Dr Ferrante is a Researcher, National Institute of Health, Rome, Italy. stefano.pompei1@tin.it.
Polyurethane (PU) foam implants significantly reduce capsular contracture (CC) risk in breast reconstruction. Radiation therapy increases CC risk, but PU implants mitigate this effect, even with radiotherapy.
Area of Science:
- Plastic Surgery
- Biomaterials Science
Background:
- Capsular contracture (CC) is a significant complication following breast augmentation and reconstruction using smooth or textured implants.
- Polyurethane (PU) foam-coated breast implants were developed as a strategy to reduce the incidence of CC.
Purpose of the Study:
- To evaluate the incidence of capsular contracture (CC) in patients undergoing two-stage breast reconstruction with PU foam-covered implants.
- To compare CC rates in patients who received radiation therapy versus those who did not.
Main Methods:
- Retrospective review of 92 patients with 115 PU implants.
- Kaplan-Meier analysis and log-rank test to compare CC rates over time between irradiated and nonirradiated groups.
- Analysis of CC rates in relation to patient age.
Main Results:
- The overall 9-year cumulative incidence of CC was 8.1%.
- The 9-year cumulative incidence of CC was 10.7% in the irradiated group and 5.5% in the nonirradiated group.
- CC occurred earlier in the irradiated group (within 3 years) compared to the nonirradiated group (within 7 years).
Conclusions:
- Radiation therapy is associated with an increased risk of high-grade capsular contracture (CC) with various implant types.
- PU foam-coated implants demonstrate a substantially lower cumulative incidence of CC in two-stage breast reconstruction, even in patients undergoing radiotherapy.
- Younger patients may have a higher incidence of CC.
