This study reported on the authors’ experience of using polyurethane implants for prepectoral direct-to-implant (DTI) breast reconstruction, focusing on safety and feasibility.1 A total of 63 patients were included in this prospective study, with 74 reconstructions. All patients underwent nipple-sparing mastectomy and immediate breast reconstruction with micro-polyurethane foam–coated anatomic implants. The authors used standardized assessments to report preoperative patient characteristics and postoperative complications. At a median follow-up of 12 months, they reported the following complications: seroma (5.4%), hematoma (2.7%), infection (4%), unplanned readmission (6.7%), implant loss within 3 months (6.7%), and rippling/edge visibility (8.1%). There were no cases of capsular contracture or implant rotation or malposition. The authors concluded that polyurethane-coated implants may prevent rotation and malposition and capsular contracture in the short term but unplanned readmission and implant loss rates may be slightly higher.
Polyurethane foam coating of silicone implants was introduced in 1968, followed by introduction of implant texturization 2 decades later. The aim of the design was to reduce incidence of capsular contracture. It is now well-established that the polyurethane layer does indeed mitigate the risk of capsular contracture.2-4 In addition, the polyurethane surface adheres to breast tissue, eliminating dead space and preventing fluid accumulation, and stabilizes the implant. These qualities reduce the risk of seroma and implant rotation and malposition, respectively. The results from this study further contribute to the evidence regarding the beneficial effects of polyurethane coating.
(note: this article is not open access)