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Types of Errors Made During Breast Augmentation with Polyurethane Implants: A Systematic Review

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Abstract

Background

Implementation of polyurethane-covered (PU) implants into practice requires a reassessment of the experience and a learning curve period. Occasional publications describe a few difficulties in this regard. However, there are no publications covering the spectrum of errors. The absence of definite information and contradictory findings makes the learning curve longer leading to many unsatisfactory results.

Materials and Methods

The systematization is based on the 12 years of experience with over 1000 patients and previously published data. A literature review was conducted using PUBMED with the following keywords: polyurethane or foam or sponge and breast and implant. A total of 285 articles were found (last accessed 08/13/2019). All articles concerning polyurethane implants were studied along with any articles found describing the surgical techniques applied to them. Additional references found in the above-mentioned articles were also included in the study.

Results

All errors can be divided into planning errors, errors in pocket development and surface-dependent errors, for which the polyurethane surface is the main reason. Surface-dependent errors include the errors connected to positioning and biointegration. The possible causes of late seroma with PU implants are discussed.

Conclusions

The polyurethane surface should not be considered textured in the clinical point of view. Previous experience with non-PU implants cannot be transferred to PU implants. The learning curve is unavoidable. The systematization of errors with PU implants facilitates a decision-making process during the primary and secondary surgery and lowers the risk of the unsatisfactory results.

Level of Evidence IV

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Author information

Correspondence to D. Batiukov.

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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.

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Electronic Supplementary Material

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Video 1. Positioning error. Both implants are bended anteriorly in this patient (MP4 14430 kb)

Video 2. Positioning error (implant-tissue interactions). Double bubble formation (MP4 19988 kb)

Video 3. Biointegration error. Only the second sheeting of PU implant remained attached to the tissues in the long term (MP4 26360 kb)

Video 1. Positioning error. Both implants are bended anteriorly in this patient (MP4 14430 kb)

Video 2. Positioning error (implant-tissue interactions). Double bubble formation (MP4 19988 kb)

Video 3. Biointegration error. Only the second sheeting of PU implant remained attached to the tissues in the long term (MP4 26360 kb)

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Batiukov, D., Podgaiski, V. & Ladutko, D. Types of Errors Made During Breast Augmentation with Polyurethane Implants: A Systematic Review. Aesth Plast Surg 44, 70–79 (2020). https://doi.org/10.1007/s00266-019-01510-6

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Keywords

  • Polyurethane implants
  • Breast augmentation
  • Secondary breast surgery
  • High-riding implants
  • Implant malposition
  • Bottoming out