Breast Prostheses: A Critical Review

Szycher, Michael; Lee, Steven J.; Siciliano, Arthur A.

doi:10.1177/088532829100500402

Cited by 10 publications

(6 citation statements)

References 89 publications

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“…By-products from aromatic polyurethane degradation can lead to carcinogenic or mutagenic compounds. 105 Employing monomers derived from the amino acids lysine and tyrosine, biodegradable and more biocompatible polyurethanes with a range of mechanical properties have been produced. Utilizing a lysine diisocyanate in the hard domain, the resulting polyurethanes could be tuned from elastomeric, with an elongation-at-break of $1000%, to a brittle polymer, with modulus of 49 MPa and elongation-at-break of $6.7%.…”

Section: Non-canonical Amino Acids -Synthetic Evolutionmentioning

confidence: 99%

Enhanced mechanical pathways through nature's building blocks: amino acids

Johnson

Korley

2012

Soft Matter

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Section: Non-canonical Amino Acids -Synthetic Evolutionmentioning

confidence: 99%

Enhanced mechanical pathways through nature's building blocks: amino acids

Johnson

Korley

2012

Soft Matter

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“…Breast implants are employed since 1962, when Cronin and Gerow performed the first breast augmentation [ 1 ]. Since then, capsular contracture (CC) has represented the most common complication after breast implants insertion, and the leading cause for re-intervention [ [2] , [3] , [4] ]. Capsular contracture represents a normal reaction against the breast implant forming fibrous scar tissue around it, creating a tissue capsule [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Immediate Breast Reconstruction after mastectomy with polyurethane implants versus textured implants: A retrospective study with focus on capsular contracture

et al. 2020

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Background: Capsular contracture (CC) is the most common complication following Immediate Breast Reconstruction (IBR) with breast implants. Different implant surfaces were developed aiming to reduce the incidence of CC. We evaluated the incidence and degree of CC after Direct-to-Implant (DTI) IBR with insertion of textured (TE) or polyurethane (PU) covered implants. Methods: A retrospective review of consecutive patients treated at our Institution with mastectomy and one-stage IBR and implant reconstruction between 2013 and 2018, with or without post mastectomy radiation therapy (PMRT), was conducted. Immediate breast reconstruction was performed by implanting 186 PU covered implants and 172 TE implants. Results: Three-hundred-twelve women underwent 358 DTI IBR with PU or TE implants, were analyzed with a median follow-up time of 2.3 years (range 1.0e3.0). The overall rate of CC Baker grade III and IV was 11.8% (95%CI: 8.4e16.3), while, after PU and TE implant placement it was 8.1% (95% CI: 4.1e15.7) and 15.8% (95% CI: 4.1e15.7) [p ¼ 0.009]), respectively. Irradiated breasts developed CC more frequently rather than non-irradiated breasts (HR ¼ 12.5, p < 0.001), and the relative risk was higher in the TE group compared with the PU group (HR ¼ 0.3, p ¼ 0.003). Conclusions: After mastectomy and one-stage IBR, the use of PU covered implants is associated with a lower incidence of CC compared to TE implants. This advantage is amplified several folds for patients who necessitate PMRT. Footnote: Capsular contracture (CC); Immediate Breast Reconstruction (IBR); Directto-Implant (DTI); Textured (TE); Polyurethane (PU); Post mastectomy radiation therapy (PMRT); Nipple Sparing mastectomy (NSM).

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“…Beyond these concentrations, the degradation products may have detrimental effects upon cells. Since cyclic and aromatic diisocyanates are known to be carcinogenic and cytotoxic, 31,32 the high threshold value for PCL-C-DTH and PEG-C-DTH cytotoxicities is surprising, yet the implications of these results in vivo are ambiguous, 31,32 since the threshold concentrations of the cytotoxic components may never be exceeded.…”

Section: Discussionmentioning

confidence: 99%

Cellular interactions with biodegradable polyurethanes formulated from L-tyrosine

Shah

Yun

2011

J Biomater Appl

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L-Tyrosine polyurethanes (LTUs) have been synthesized by structural modification of the poly (amino acid) backbone to circumvent the problems associated with the processing of poly (amino acids) arising from their high crystallinity, insolubility in common organic solvents, and high glass-transition and melting temperatures. Additionally, problems such as unpredictable swelling characteristics, change in conformation, and uncontrolled enzymatic degradation have severely restricted the use of poly (amino acids). In contrast, LTUs are designed to retain their superior physico-chemical properties, while incorporating biodegradability through enzymatic, hydrolytic, and oxidative pathways. The aim of this study is to evaluate initially the biocompatibility of LTUs and their degradation products. Studies involving primary dermal human fibroblasts cultured in contact with LTU films or degradation products suggest a lack of toxicity (cell viabilities >93% with p < 0.05 compared to the control for all studies). The diversity of LTU polymer chemistry and the ability of LTUs to phase separate seem to present a heterogeneous surface with variable wettability. This phenomenon influences the adhesion and proliferation of human fibroblasts on polymeric surfaces, wherein fibroblast adhesion on polycaprolactone diol (PCL) based LTUs is characterized by higher cell counts (81,250 ± 18,390 for PCL-C-DTH (desaminotyrosine-tyrosyl hexyl, DTH), 58,360 ± 7370 for PCL-L-DTH, 38,480 ± 12,680 for PEG-C-DTH (polyethylene glycol, PEG), and 46,430 ± 16,000 for PEG-L-DTH at 120 h with p < 0.001 for comparison between PCL-C-DTH and all other LTUs), more rapid cellular proliferation (doubling time of 37-49 h for PCL-based LTUs compared to 68-90 h for PEG-based LTUs), and a uniform cell distribution compared to PEG-based LTUs. However, immunofluorescence assay for F-actin suggests that the cells are well attached. Thus, the lack of cytotoxicity and the ability to control cellular adhesion through polymer chemistry make LTUs attractive candidates for tissue-engineering applications that require elastomeric, biodegradable, and biocompatible polymers.

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Breast Prostheses: A Critical Review

Cited by 10 publications

References 89 publications

Enhanced mechanical pathways through nature's building blocks: amino acids

Enhanced mechanical pathways through nature's building blocks: amino acids

Immediate Breast Reconstruction after mastectomy with polyurethane implants versus textured implants: A retrospective study with focus on capsular contracture

Cellular interactions with biodegradable polyurethanes formulated from L-tyrosine

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