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Comparative Study
. 2020 Dec:54:127-132.
doi: 10.1016/j.breast.2020.09.009. Epub 2020 Sep 29.

Immediate Breast Reconstruction after mastectomy with polyurethane implants versus textured implants: A retrospective study with focus on capsular contracture

Andrea Loreti  1 , Giacomo Siri  2 , Matteo De Carli  3 , Benedetta Fanelli  3 , Floriana Arelli  3 , Diana Spallone  3 , Ornella Abate  3 , Massimo La Pinta  4 , Elena Manna  4 , Emanuele Zarba Meli  4 , Leopoldo Costarelli  5 , Damiana Andrulli  6 , Laura Broglia  7 , Paola Scavina  8 , Lucio Fortunato  4
Affiliations
Comparative Study

Immediate Breast Reconstruction after mastectomy with polyurethane implants versus textured implants: A retrospective study with focus on capsular contracture

Andrea Loreti et al. Breast. 2020 Dec.

Abstract

Background: Capsular contracture (CC) is the most common complication following Immediate Breast Reconstruction (IBR) with breast implants. Different implant surfaces were developed aiming to reduce the incidence of CC. We evaluated the incidence and degree of CC after Direct-to-Implant (DTI) IBR with insertion of textured (TE) or polyurethane (PU) covered implants.

Methods: A retrospective review of consecutive patients treated at our Institution with mastectomy and one-stage IBR and implant reconstruction between 2013 and 2018, with or without post mastectomy radiation therapy (PMRT), was conducted. Immediate breast reconstruction was performed by implanting 186 PU covered implants and 172 TE implants.

Results: Three-hundred-twelve women underwent 358 DTI IBR with PU or TE implants, were analyzed with a median follow-up time of 2.3 years (range 1.0-3.0). The overall rate of CC Baker grade III and IV was 11.8% (95%CI: 8.4-16.3), while, after PU and TE implant placement it was 8.1% (95% CI: 4.1-15.7) and 15.8% (95% CI: 4.1-15.7) [p = 0.009]), respectively. Irradiated breasts developed CC more frequently rather than non-irradiated breasts (HR = 12.5, p < 0.001), and the relative risk was higher in the TE group compared with the PU group (HR = 0.3, p = 0.003).

Conclusions: After mastectomy and one-stage IBR, the use of PU covered implants is associated with a lower incidence of CC compared to TE implants. This advantage is amplified several folds for patients who necessitate PMRT. Footnote: Capsular contracture (CC); Immediate Breast Reconstruction (IBR); Directto- Implant (DTI); Textured (TE); Polyurethane (PU); Post mastectomy radiation therapy (PMRT); Nipple Sparing mastectomy (NSM).

Keywords: Capsular contracture; Immediate breast reconstruction; Polyurethane breast implants; Post mastectomy radiation therapy; Textured breast implants.

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Figures

Fig. 1
Fig. 1
Kaplan-Meier estimates of incidence of capsular contracture (CC) after one-stage breast reconstruction. Thirty-two cases of CC occurred within a median follow-up of 3 years.
Fig. 2
Fig. 2
Kaplan-Meier estimates of incidence of capsular contracture (CC) after one-stage breast reconstruction according to irradiation status and type of breast implants.
See this image and copyright information in PMC

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