Polyurethane-Coated Breast Implants Revisited: A 30-Year Follow-Up
Background Polyurethane coating of breast implants has been shown to reduce capsular contracture in short-term follow-up studies. This 30-year study is the longest examination of the use of polyurethane-coated implants and their correlation with capsular contracture. Methods This study...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2015-03-01
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| Series: | Archives of Plastic Surgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2015.42.2.186 |
| _version_ | 1798037737265168384 |
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| author | Nikki Castel Taylor Soon-Sutton Peter Deptula Anna Flaherty Fereydoun Don Parsa |
| author_facet | Nikki Castel Taylor Soon-Sutton Peter Deptula Anna Flaherty Fereydoun Don Parsa |
| author_sort | Nikki Castel |
| collection | DOAJ |
| description | Background Polyurethane coating of breast implants has been shown to reduce capsular contracture in short-term follow-up studies. This 30-year study is the longest examination of the use of polyurethane-coated implants and their correlation with capsular contracture.
Methods This study evaluates the senior surgeon's (F.D.P.) experience with the use of polyurethane-coated implants in aesthetic breast augmentation in 382 patients over 30 years. Follow-up evaluations were conducted for six months after surgery. After the six-month follow-up period, 76 patients returned for reoperation. The gross findings, histology, and associated capsular contracture were noted at the time of explantation.
Results No patient during the six-month follow-up period demonstrated capsular contracture. For those who underwent reoperation for capsular contracture, Baker II/III contractures were noted nine to 10 years after surgery and Baker IV contractures were noted 12 to 21 years after surgery. None of the explanted implants had macroscopic evidence of polyurethane, which was only found during the first five years after surgery. The microscopic presence of polyurethane was noted in all capsules up to 30 years after the original operation.
Conclusions An inverse correlation was found between the amount of polyurethane coating on the implant and the occurrence of capsular contracture. Increasingly severe capsular contracture was associated with a decreased amount of polyurethane coating on the surface of the implants. No contracture occurred in patients whose implants showed incomplete biodegradation of polyurethane, as indicated by the visible presence of polyurethane coating. We recommend research to find a non-toxic, non-biodegradable synthetic material as an alternative to polyurethane. |
| first_indexed | 2024-04-11T21:30:37Z |
| format | Article |
| id | doaj.art-be122addf9a04f308b344ea3b8409de2 |
| institution | Directory Open Access Journal |
| issn | 2234-6163 2234-6171 |
| language | English |
| last_indexed | 2024-04-11T21:30:37Z |
| publishDate | 2015-03-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Archives of Plastic Surgery |
| spelling | doaj.art-be122addf9a04f308b344ea3b8409de22022-12-22T04:02:01ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712015-03-01420218619310.5999/aps.2015.42.2.186476Polyurethane-Coated Breast Implants Revisited: A 30-Year Follow-UpNikki Castel0Taylor Soon-Sutton1Peter Deptula2Anna Flaherty3Fereydoun Don Parsa4Department of Surgery, Division of Plastic Surgery, University of Hawai'i, John A. Burns School of Medicine, Honolulu, HI, USADepartment of Surgery, Division of Plastic Surgery, University of Hawai'i, John A. Burns School of Medicine, Honolulu, HI, USADepartment of Surgery, Division of Plastic Surgery, University of Hawai'i, John A. Burns School of Medicine, Honolulu, HI, USADepartment of Surgery, Division of Plastic Surgery, University of Hawai'i, John A. Burns School of Medicine, Honolulu, HI, USADepartment of Surgery, Division of Plastic Surgery, University of Hawai'i, John A. Burns School of Medicine, Honolulu, HI, USABackground Polyurethane coating of breast implants has been shown to reduce capsular contracture in short-term follow-up studies. This 30-year study is the longest examination of the use of polyurethane-coated implants and their correlation with capsular contracture. Methods This study evaluates the senior surgeon's (F.D.P.) experience with the use of polyurethane-coated implants in aesthetic breast augmentation in 382 patients over 30 years. Follow-up evaluations were conducted for six months after surgery. After the six-month follow-up period, 76 patients returned for reoperation. The gross findings, histology, and associated capsular contracture were noted at the time of explantation. Results No patient during the six-month follow-up period demonstrated capsular contracture. For those who underwent reoperation for capsular contracture, Baker II/III contractures were noted nine to 10 years after surgery and Baker IV contractures were noted 12 to 21 years after surgery. None of the explanted implants had macroscopic evidence of polyurethane, which was only found during the first five years after surgery. The microscopic presence of polyurethane was noted in all capsules up to 30 years after the original operation. Conclusions An inverse correlation was found between the amount of polyurethane coating on the implant and the occurrence of capsular contracture. Increasingly severe capsular contracture was associated with a decreased amount of polyurethane coating on the surface of the implants. No contracture occurred in patients whose implants showed incomplete biodegradation of polyurethane, as indicated by the visible presence of polyurethane coating. We recommend research to find a non-toxic, non-biodegradable synthetic material as an alternative to polyurethane.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2015.42.2.186polyurethanesimplant capsular contracturebreast implants |
| spellingShingle | Nikki Castel Taylor Soon-Sutton Peter Deptula Anna Flaherty Fereydoun Don Parsa Polyurethane-Coated Breast Implants Revisited: A 30-Year Follow-Up Archives of Plastic Surgery polyurethanes implant capsular contracture breast implants |
| title | Polyurethane-Coated Breast Implants Revisited: A 30-Year Follow-Up |
| title_full | Polyurethane-Coated Breast Implants Revisited: A 30-Year Follow-Up |
| title_fullStr | Polyurethane-Coated Breast Implants Revisited: A 30-Year Follow-Up |
| title_full_unstemmed | Polyurethane-Coated Breast Implants Revisited: A 30-Year Follow-Up |
| title_short | Polyurethane-Coated Breast Implants Revisited: A 30-Year Follow-Up |
| title_sort | polyurethane coated breast implants revisited a 30 year follow up |
| topic | polyurethanes implant capsular contracture breast implants |
| url | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2015.42.2.186 |
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