Types of Errors Made During Breast Augmentation with Polyurethane Implants: A Systematic Review

Area of Science:

• Plastic Surgery
• Biomaterials Science
• Surgical Complications

Background:

• Implementation of polyurethane-covered (PU) implants necessitates a reassessment of surgical experience and a learning curve.
• Existing literature lacks comprehensive coverage of the spectrum of errors associated with PU implants, leading to prolonged learning curves and suboptimal outcomes.
• Contradictory findings in occasional publications further complicate the understanding and management of PU implant-related issues.

Purpose of the Study:

• To systematize the errors encountered with polyurethane-covered breast implants.
• To provide a framework for decision-making in primary and secondary surgeries involving PU implants.
• To reduce the incidence of unsatisfactory results by addressing the learning curve associated with PU implant use.

Main Methods:

• Systematization based on 12 years of experience with over 1000 patients.
• Comprehensive literature review of polyurethane breast implants using PUBMED (keywords: polyurethane, foam, sponge, breast, implant).
• Analysis of 285 identified articles, including those detailing surgical techniques and additional references.

Main Results:

• Errors associated with PU implants are categorized into planning, pocket development, and surface-dependent errors.
• The polyurethane surface is identified as the primary cause of surface-dependent errors, impacting positioning and biointegration.
• Potential causes for late seroma development with PU implants are discussed.

Conclusions:

• The polyurethane surface should not be clinically considered textured.
• Surgical experience with non-PU implants is not directly transferable to PU implants.
• A structured understanding of PU implant errors is crucial for navigating the learning curve and improving surgical outcomes.