Polyurethane Implants in Revision Breast Augmentation: A Prospective 5-Year Study.

BACKGROUND: Revision surgery for aesthetic breast augmentation remains a challenging procedure. Polyurethane (PU) implants have been found to avoid capsular contracture recurrence as well as prevent implant displacement by bio-integrating into the pocket.

OBJECTIVES: Our study aims to assess the use of PU in breast revision surgery and provides an algorithm.

METHODS: Over a 5-year period, a prospective study was conducted involving consecutive patients undergoing implant revision. Patient demographics, previous breast procedures, and specific surgical details were documented. Post-operative outcomes were followed up.

RESULTS: Out of 92 patients (184 breasts), 78 (156 breasts) were included in the analysis. The average age was 47.4, with a BMI of 22.3, and a mean follow-up of 5 years. A majority (63%) represented secondary revision cases, while 37% were tertiary cases. Implant size averaged 296 cc, with 53% placed retropectoral and 47% prepectoral. Significantly more implants in secondary cases were changed from pre- to retropectoral (p = 0.005), and in tertiary changed from retro- to prepectoral (p = 0.002). Complete capsulectomy was performed in 61.5% and partial in 25.6%. Additional lipofilling was performed in 32%, and concurrent mastopexy in 40%. Revision surgery in our series had a 1.9% acute complication rate, 4.5% longer term re-operation rate for corrections, 0.6% implant exchange rate, and no recurrent capsular contracture.

CONCLUSIONS: This is the first study to provide data on outcomes of revision breast augmentation surgery with the use of PU implants. It shows that polyurethane implants offer consistent stability and have low rates of recurrent capsular contracture in revision surgery.