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

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Aesthetic Plastic Surgery
|October 9, 2019
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Summary

Polyurethane (PU) breast implants require a learning curve due to unique surface-related errors. Systematizing these errors helps surgeons improve outcomes and reduce unsatisfactory results with PU implants.

Keywords:
Bottoming outBreast augmentationHigh-riding implantsImplant malpositionPolyurethane implantsSecondary breast surgery

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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.