Nonadherence of Polyurethane Implants: A Retrospective Cohort Study.

Area of Science:

• Plastic Surgery
• Biomaterials Science
• Surgical Complications

Background:

• Biointegration of polyurethane (PU) implants is crucial for stable positioning and predictable outcomes in breast augmentation and reconstruction.
• While generally reliable, rare cases of PU implant nonadherence to surrounding tissues can occur, leading to complications.
• Understanding the incidence and causes of PU implant nonadherence is essential for improving patient results.

Purpose of the Study:

• To determine the incidence of PU implant nonadherence after primary breast augmentation and augmentation mastopexy with dual plane placement.
• To analyze potential causes contributing to PU implant nonadherence.
• To propose preventive measures and treatment strategies for this complication.

Main Methods:

• Analysis of 333 patients undergoing primary aesthetic surgeries with dual plane PU implant placement.
• Clinical evaluation and comparison of pre- and post-operative images and videos.
• Focused assessment of implant position changes and asymmetry development over time.

Main Results:

• PU implant nonadherence was identified in seven patients (2.1% overall incidence).
• Primary nonadherence occurred in 0.6% of cases, while secondary nonadherence was observed in 1.5%.
• Potential contributing factors included traumatic surgical technique, seroma, hematoma, and physical trauma.

Conclusions:

• Mandatory biointegration of PU implants ensures long-term predictable results in breast procedures.
• PU implant nonadherence results in malposition and associated complications, similar to non-PU implants.
• Enhancements in surgical maneuvers, manufacturing processes, and implant weight reduction may improve stability.