Breast reconstruction with polyurethane implants: preliminary report

Abstract

Today, immediate breast reconstruction is widely accepted in breast cancer surgery. There are many reconstruction procedures that combine cancer indications with patient's expectations. Improved techniques in the use of textured or polyurethane-coated implants and tissue expanders, associated with increasingly more conservative mastectomy procedures, may result in better cosmetic outcomes and less complications, even in patients that require postoperative radiotherapy. From June 2002 to December 2008, 166 unilateral breast reconstructions were performed immediately using definite prosthesis with polyurethane-coated (6) or textured (24) implants, or later, after implant of 136 tissue expanders, using polyurethanecoated (113) or textured (23) implants. Eighty-six two-stage breast reconstructions were irradiated where later 63 polyurethane-coated implants and 23 textured implants have been inserted. Results were analysed evaluating complications associated with temporary expanders and with the two definite implants, with or without RT, respectively. Excluding capsular contracture, total complication rate was 14.7% with expanders, 5.0% with polyurethane implants and 12.8% with textured implants. In this study, severe capsular contracture was reported in 21.7% of cases with textured prosthesis and in 6.3% of cases with polyurethane implants in patients receiving RT. This difference was statistically significant. As of today, no case of clinically noticeable capsular contracture was seen in non-irradiated patients receiving breast reconstruction with polyurethane-coated implants. These results allow us to establish RT, which is not a severe contraindication to breast reconstruction with implants. Polyurethane implants have provided encouraging results either in terms of lower complication rate and likelihood of capsular contracture.

Capsular Contracture after Breast Augmentation: An Update for Clinical Practice

“…Polyurethane coated breast implants provide a textured outer surface and have been researched recently due to the reported associated low capsular contracture incidence rates. A recent study by Pompei et al [ 54 ] looked at their use following radiotherapy, a recognised risk factor associated with capsular contracture. They found that capsular contracture occurred in 6.3% of patients who used polyurethane coated implants whereas those who had expanded textured implants inserted reported a rate of 21.7%.…”

Outcome of complete acellular dermal matrix wrap with polyurethane implant in immediate prepectoral breast reconstruction

“…Another retrospective study by Pompei et al [24] looked into the impact of radiotherapy on capsular contracture depending on the type of implant being used. Patient demographics, postoperative complications and cosmetic outcome were also recorded.…”

Long-term impact of lipofilling in hybrid breast reconstruction: retrospective analysis of two cohorts

“…Deflation-lipofilling sessions are conducted to prevent complications during the reconstructive step, limiting the onset of postoperative complications. As other authors promote the use of polyurethane implants as a first step in breast reconstruction to reduce complication rates [40,41] and not only as a rescue tool after a failure, in the same way, the present study investigated the beneficial effect of fat grafting as a part of the standard two-stage breast implant reconstruction for all postmastectomy patients in order to reduce overall capsular contracture and improve the esthetic result. This is the first report of 84 patients, a case-control study, with a mean follow-up time of 34.87 months.…”