A Simple Method to Inset and Position Polyurethane-Covered Breast Implants



Polyurethane-covered breast implants have been used increasingly for cosmetic and revision breast surgery. The incision for insertion should be of minimal length and the placement of these implants in the pocket can be more difficult than that of conventional implants because of the highly adherent textured surface of the polyurethane external layer that grasps the surrounding tissues. The use of a sterile plastic insertion sleeve that is open on both sides is suggested by the manufacturer to overcome the friction between the polyurethane implant and the skin and surrounding tissues.


A new method to facilitate polyurethane implant insertion and adjustment in all cases of primary breast augmentation and revision surgery is presented. After the implant, which is in the sleeve, is located in the pocket, the plastic sleeve is filled with saline and antibiotics so the solution lubricates the surface around the implant. The sleeve is then twisted so that the solution is squeezed inside the pocket while the sleeve itself is pulled back and removed.


Between 2010 and 2013, this method was used in 73 cases of primary augmentation and revision breast surgery without any complications.


The method described here allows for easier removal of the plastic sleeve during polyurethane implant insertion without any complications or evidence of implant migration or rotation at follow-up.

Level of Evidence IV

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Conflict of interest

The authors have no financial interest to declare in relation to the content of this article.

Author information

Correspondence to Yi Xin Zhang.

Additional information

Manuel Francisco Castello, Sheng Han and Alessandro Silvestri have contributed equally to this work.

Electronic supplementary material

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Video 1 The authors’ technique step-by-step (WMV 31311 kb)

Video 1 The authors’ technique step-by-step (WMV 31311 kb)

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Castello, M.F., Han, S., Silvestri, A. et al. A Simple Method to Inset and Position Polyurethane-Covered Breast Implants. Aesth Plast Surg 38, 365–368 (2014).

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  • Polyurethane-covered implant
  • Location
  • Plastic insertion sleeve
  • Breast augmentation
  • Breast revision surgery