Advertisement

Removal of Polyurethane Implants

  • D. Batiukov
  • V. Podgaiski
  • D. Ladutko
Original Article Breast Surgery
  • 42 Downloads

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

This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Keywords

Removal of polyurethane implants Breast augmentation Secondary breast surgery Capsulectomy 

Notes

Compliance with Ethical Standards

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

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

References

  1. 1.
    Buckspan R (1989) Inserting the polyurethane-covered breast implant. Plast Reconstr Surg 84(5):858–859CrossRefGoogle Scholar
  2. 2.
    Smith M, Durrani A (2011) Aiding the insertion of polyurethane coated breast implants. Ann R Coll Surg Engl 93(7):556CrossRefGoogle Scholar
  3. 3.
    Batich C, Williams J (1989) Toxic hydrolysis product from biodegradable foam implant. J Biomed Mater Res 23:311–319CrossRefGoogle Scholar
  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):756–758PubMedGoogle Scholar
  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):2143–2145PubMedGoogle Scholar
  6. 6.
    Brand K (1988) Foam-covered mammary implants. Clin Plast Surg 15(4):533–539PubMedGoogle Scholar
  7. 7.
    Jabaley M, Das S (1986) Late breast pain following reconstruction with polyurethane-covered implants. Plast Reconstr Surg 78(3):390–395CrossRefGoogle Scholar
  8. 8.
    Hoffman S (1989) Correction of established capsular contractures with polyurethane implants. Aesthet Plast Surg 13(1):33–40CrossRefGoogle Scholar
  9. 9.
    Wang B, Chang B, Sargeant R, Manson P (1998) Late capsular hematoma after breast reconstruction with polyurethane covered implants. Plast Reconstr Surg 102:450–452CrossRefGoogle Scholar
  10. 10.
    Brickman M, Parsa N, Parsa F (2004) Late hematoma after breast implantation. Aesthet Plast Surg 28:80–82CrossRefGoogle Scholar
  11. 11.
    Eyssen J, von Werssowetz A, Middleton G (1984) Reconstruction of the breast using polyurethane-coated prostheses. Plast Reconstr Surg 73:415–421CrossRefGoogle Scholar
  12. 12.
    Pollock H (1984) Polyurethane-covered breast implants. Plast Reconstr Surg 74:729CrossRefGoogle Scholar
  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):49–51CrossRefGoogle Scholar
  14. 14.
    Capozzi A (1991) Long-term complications of polyurethane-covered breast implants. Plast Reconstr Surg 88(3):458–461CrossRefGoogle Scholar
  15. 15.
    Hester T (1990) Diagnosis and treatment of complications occurring with polyurethane-covered breast implants. Perspect Plast Surg 4:105–111Google Scholar
  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 96–120CrossRefGoogle Scholar
  17. 17.
    Ashley FL (1970) A new type of breast prosthesis. Preliminary report. Plast Reconstr Surg 45(5):421–424CrossRefGoogle Scholar
  18. 18.
    Vázquez G, Pellón A (2007) Polyurethane-coated silicone gel breast implants used for 18 years. Aesthet Plast Surg 31(4):330–336CrossRefGoogle Scholar
  19. 19.
    Frame J (2016) Commentary on: the modern polyurethane-coated implant in breast augmentation: long-term clinical experience. Aesthet Surg J 36(10):1130–1132CrossRefGoogle Scholar
  20. 20.
    Schatten W (1984) Reconstruction of breast following mastectomy with polyurethane-covered, gel-filled prosthesis. Ann Plast Surg 12:147–156CrossRefGoogle Scholar
  21. 21.
    Hester T (1988) The polyurethane covered mammary prosthesis: facts and fiction. Perspect Plast Surg 2:135–164Google Scholar
  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):475–481CrossRefGoogle Scholar
  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):503–509CrossRefGoogle Scholar
  24. 24.
    Vasquez G (1999) A ten-year experience using polyurethane covered breast implants. Aesthet Plast Surg 23:189–196CrossRefGoogle Scholar
  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 36:331–338CrossRefGoogle Scholar
  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):186–193CrossRefGoogle Scholar
  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):452–460CrossRefGoogle Scholar
  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):1124–1129CrossRefGoogle Scholar
  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):171–176CrossRefGoogle Scholar
  30. 30.
    Stan C, Biggs T (2017) The diagon/gel implant: a preliminary report of 894 cases. Plast Reconstr Surg Glob Open 5(7):e1393CrossRefGoogle Scholar
  31. 31.
    Gasperoni C, Salgarello M, Gargani G (1992) Polyurethane-covered mammary implants: a 12-year experience. Ann Plast Surg 29(4):303–308CrossRefGoogle Scholar
  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 39:713–723CrossRefGoogle Scholar
  33. 33.
    O’Connell J (1992) Removal of stacked polyurethane-covered mammary implants. Plast Reconstr Surg 90(5):930–931CrossRefGoogle Scholar
  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 65:1425–1429CrossRefGoogle Scholar
  35. 35.
    Ashley F (1972) A further studies on the natural-Y breast prothesis. Plast Reconstr Surg 49(4):414–419CrossRefGoogle Scholar
  36. 36.
    Melmed E (1988) Polyurethane implants: a 6-year review of 416 patients. Plast Reconstr Surg 82(2):285–290CrossRefGoogle Scholar
  37. 37.
    Hoefflin S (1990) Extensive experience with polyurethane breast implants. Plast Reconstr Surg 86(1):166–167CrossRefGoogle Scholar
  38. 38.
    Miro A (2009) Polyurethane-coated silicone breast implants: evaluation of 14 years experience. Rev Bras Cir Plast 24(3):296–303Google Scholar
  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):549–553CrossRefGoogle Scholar
  40. 40.
    Dini G, Ferreira L (2006) Early complication with the use of polyurethane-covered breast implants. Plast Reconstr Surg 117(6):2098–2100CrossRefGoogle Scholar
  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):1655–1657CrossRefGoogle Scholar
  42. 42.
    Gruver D (1989) Managing the patient with infection around a polyurethane implant. Plast Reconstr Surg 83(5):927CrossRefGoogle Scholar
  43. 43.
    Cohney B, Mitchell S (1997) An improved method of removing polyurethane foam-covered gel prostheses. Aesthet Plast Surg 21:191–192CrossRefGoogle Scholar
  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):819–820CrossRefGoogle Scholar
  45. 45.
    Hall-Findlay E (2011) Breast implant complication review: double capsules and late seromas. Plast Reconstr Surg 127:56–66CrossRefGoogle Scholar
  46. 46.
    Scarpa C, Borso G, Vindigni V, Bassetto F (2015) Polyurethane foam-covered breast implants: A justified choice? Eur Rev Med Pharmacol Sci 19:1600–1606PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  1. 1.Medical Center “Antes Med”MinskBelarus
  2. 2.Belorussian Medical Academy of Postgraduate EducationMinskBelarus
  3. 3.Department of MicrosurgeryMinsk Regional HospitalMinsk Region, LesnojBelarus

Personalised recommendations