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Removal of Polyurethane Implants

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Abstract

Polyurethane (PU) implants are associated with great difficulties in extraction if secondary surgery is needed. The published data are contradictory, often misleading, making the decision for the secondary surgery complicated, the time period and the procedure itself not optimal, thus negatively influencing the final result.

Materials and Methods

Typical videos of PU implant removal in different periods after primary surgeries with polyurethane implants were selected for the study. The videos show the strength and extent of the tissue ingrowth and the manipulations needed for implant extraction in different periods from the initial procedure. Classifications of the types of adhesion and adhesion patterns are introduced.

Conclusions

The data provided in this article facilitate the decision-making process if secondary surgery is indicated. Secondary surgery should be performed in the first 30 days after the initial surgery or in the period after 6 months. The optimal layer for removal of the PU implant depends on the time after the primary surgery. The polyurethane implant should be exchanged after 1 month if the properties of the polyurethane foam are expected to be used.

Level of Evidence IV

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References

  1. 1.

    Buckspan R (1989) Inserting the polyurethane-covered breast implant. Plast Reconstr Surg 84(5):858–859

  2. 2.

    Smith M, Durrani A (2011) Aiding the insertion of polyurethane coated breast implants. Ann R Coll Surg Engl 93(7):556

  3. 3.

    Batich C, Williams J (1989) Toxic hydrolysis product from biodegradable foam implant. J Biomed Mater Res 23:311–319

  4. 4.

    Chan S, Birdsell D, Gradeen C (1991) Detection of toluenediamines in the urine of a patient with polyurethane-covered breast implants. Clin Chem 37(5):756–758

  5. 5.

    Chan S, Birdsell D, Gradeen C (1991) Urinary excretion of free toluenediamines in a patient with polyurethane-covered breast implants. Clin Chem 37(12):2143–2145

  6. 6.

    Brand K (1988) Foam-covered mammary implants. Clin Plast Surg 15(4):533–539

  7. 7.

    Jabaley M, Das S (1986) Late breast pain following reconstruction with polyurethane-covered implants. Plast Reconstr Surg 78(3):390–395

  8. 8.

    Hoffman S (1989) Correction of established capsular contractures with polyurethane implants. Aesthet Plast Surg 13(1):33–40

  9. 9.

    Wang B, Chang B, Sargeant R, Manson P (1998) Late capsular hematoma after breast reconstruction with polyurethane covered implants. Plast Reconstr Surg 102:450–452

  10. 10.

    Brickman M, Parsa N, Parsa F (2004) Late hematoma after breast implantation. Aesthet Plast Surg 28:80–82

  11. 11.

    Eyssen J, von Werssowetz A, Middleton G (1984) Reconstruction of the breast using polyurethane-coated prostheses. Plast Reconstr Surg 73:415–421

  12. 12.

    Pollock H (1984) Polyurethane-covered breast implants. Plast Reconstr Surg 74:729

  13. 13.

    Okunski WJ, Chowdary RP (1987) Infected meme implants: salvage reconstruction with latissimus dorsi myocutaneous flaps and silicone implants. Aesthet Plast Surg 11(1):49–51

  14. 14.

    Capozzi A (1991) Long-term complications of polyurethane-covered breast implants. Plast Reconstr Surg 88(3):458–461

  15. 15.

    Hester T (1990) Diagnosis and treatment of complications occurring with polyurethane-covered breast implants. Perspect Plast Surg 4:105–111

  16. 16.

    Fleming D, Handel M, Gutierrez J (2012) Polyurethane foam covered breast implants. In: Peters W, Brandon H, Jerina KL, Wolf C, Young VL (eds) Biomaterials in plastic surgery. Elsevier, New York, pp 96–120

  17. 17.

    Ashley FL (1970) A new type of breast prosthesis. Preliminary report. Plast Reconstr Surg 45(5):421–424

  18. 18.

    Vázquez G, Pellón A (2007) Polyurethane-coated silicone gel breast implants used for 18 years. Aesthet Plast Surg 31(4):330–336

  19. 19.

    Frame J (2016) Commentary on: the modern polyurethane-coated implant in breast augmentation: long-term clinical experience. Aesthet Surg J 36(10):1130–1132

  20. 20.

    Schatten W (1984) Reconstruction of breast following mastectomy with polyurethane-covered, gel-filled prosthesis. Ann Plast Surg 12:147–156

  21. 21.

    Hester T (1988) The polyurethane covered mammary prosthesis: facts and fiction. Perspect Plast Surg 2:135–164

  22. 22.

    Handel N, Silverstein M, Jensen J, Collins A, Zierk K (1991) Comparative experience with smooth and polyurethane breast implants using the Kaplan–Meier method of survival analysis. Plast Reconstr Surg 88(3):475–481

  23. 23.

    Hester T, Cukic J (1991) Use of stacked polyurethane—covered mammary implants in aesthetic and reconstructive breast surgery. Plast Reconstr Surg 88(3):503–509

  24. 24.

    Vasquez G (1999) A ten-year experience using polyurethane covered breast implants. Aesthet Plast Surg 23:189–196

  25. 25.

    de la Pen˜a-Salcedo J, Soto-Miranda M, Lopez-Salguero J (2012) Back to the future: a 15-year experience with polyurethane foam-covered breast implants using the partial-subfascial technique. Aesthet Plast Surg 36:331–338

  26. 26.

    Castel N, Soon-Sutton T, Deptula P, Flaherty A, Parsa FD (2015) Polyurethane-coated breast implants revisited: a 30-year follow-up. Arch Plast Surg 42(2):186–193

  27. 27.

    Duxbury PJ, Harvey JR (2016) Systematic review of the effectiveness of polyurethane-coated compared with textured silicone implants in breast surgery. J Plast Reconstr Aesthet Surg 69(4):452–460

  28. 28.

    Pompei S, Evangelidou D, Arelli F, Ferrante G (2016) The modern polyurethane-coated implant in breast augmentation: long-term clinical experience. Aesthet Surg J 36(10):1124–1129

  29. 29.

    Pompei S, Arelli F, Labardi L, Marcasciano F, Evangelidou D, Ferrante G (2017) Polyurethane implants in 2-stage breast reconstruction: 9-year clinical experience. Aesthet Surg J 37(2):171–176

  30. 30.

    Stan C, Biggs T (2017) The diagon/gel implant: a preliminary report of 894 cases. Plast Reconstr Surg Glob Open 5(7):e1393

  31. 31.

    Gasperoni C, Salgarello M, Gargani G (1992) Polyurethane-covered mammary implants: a 12-year experience. Ann Plast Surg 29(4):303–308

  32. 32.

    Frame J, Kamel D, Olivan M, Cintra H (2015) The in vivo pericapsular tissue response to modern polyurethane breast implants. Aesth Plast Surg 39:713–723

  33. 33.

    O’Connell J (1992) Removal of stacked polyurethane-covered mammary implants. Plast Reconstr Surg 90(5):930–931

  34. 34.

    Mossaad B, Frame J (2012) Correction of breast contour deformities using polyurethane breast implant capsule in revisional breast surgery. J Plast Reconstr Aesthet Surg 65:1425–1429

  35. 35.

    Ashley F (1972) A further studies on the natural-Y breast prothesis. Plast Reconstr Surg 49(4):414–419

  36. 36.

    Melmed E (1988) Polyurethane implants: a 6-year review of 416 patients. Plast Reconstr Surg 82(2):285–290

  37. 37.

    Hoefflin S (1990) Extensive experience with polyurethane breast implants. Plast Reconstr Surg 86(1):166–167

  38. 38.

    Miro A (2009) Polyurethane-coated silicone breast implants: evaluation of 14 years experience. Rev Bras Cir Plast 24(3):296–303

  39. 39.

    Berrino P, Galli A, Rainero M, Santi P (1986) Long-lasting complications with the use of polyurethane-covered breast implants. Br J Plast Surg 39(4):549–553

  40. 40.

    Dini G, Ferreira L (2006) Early complication with the use of polyurethane-covered breast implants. Plast Reconstr Surg 117(6):2098–2100

  41. 41.

    Prado A, Andrades P, Benitez S (2006) A word of caution on the explantation of polyurethane breast implants. Plast Reconstr Surg 117(5):1655–1657

  42. 42.

    Gruver D (1989) Managing the patient with infection around a polyurethane implant. Plast Reconstr Surg 83(5):927

  43. 43.

    Cohney B, Mitchell S (1997) An improved method of removing polyurethane foam-covered gel prostheses. Aesthet Plast Surg 21:191–192

  44. 44.

    Dini M, Giordano V, Quattrini L, Mori A, Napoli S (2011) Double capsules:our experience with polyurethane-coated silicone breast implants. Plast Reconstr Surg 128(3):819–820

  45. 45.

    Hall-Findlay E (2011) Breast implant complication review: double capsules and late seromas. Plast Reconstr Surg 127:56–66

  46. 46.

    Scarpa C, Borso G, Vindigni V, Bassetto F (2015) Polyurethane foam-covered breast implants: A justified choice? Eur Rev Med Pharmacol Sci 19:1600–1606

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Author information

Correspondence to D. Batiukov.

Ethics declarations

Conflict of interest

D. Batiukov received a speaker honorarium from POLYTECH Health & Aesthetics. V. Podgaiski and D. Ladutko declare that they have no conflict of interest.

Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Removal of PU implants 9 years, 13, 9.5 and 6 months after primary surgery

Removal of PU implants 3 months after primary surgery

Removal of PU implants 33 and 36 days after primary surgery

Removal of PU implants 21 and 6 days after primary surgery

Separation of the base of the implant from the capsule

Removal of PU implants 9 years, 13, 9.5 and 6 months after primary surgery

Removal of PU implants 3 months after primary surgery

Removal of PU implants 33 and 36 days after primary surgery

Removal of PU implants 21 and 6 days after primary surgery

Separation of the base of the implant from the capsule

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Cite this article

Batiukov, D., Podgaiski, V. & Ladutko, D. Removal of Polyurethane Implants. Aesth Plast Surg 43, 70–75 (2019). https://doi.org/10.1007/s00266-018-1254-3

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Keywords

  • Removal of polyurethane implants
  • Breast augmentation
  • Secondary breast surgery
  • Capsulectomy