Mammoplasty with the Use of Polyurethane Implants By Dr. Manuel Peralta: Safe Plastic Surgery in the Dominican Republic.
Mammoplasty is the fifth most performed procedure within the top five cosmetic surgeries listed by the American Society of Plastic Surgeons (ASPS) (1). The use of implants in breast surgery is not new—it dates back to the 1960s with the work of Drs. Gerrow and Cronin. The development of implants aims to achieve a shape and symmetry that would be nearly impossible to accomplish using the patient’s natural breast tissue alone. The introduction of polyurethane-coated implants has helped address one of the most common complications seen with smooth or textured implants: capsular contracture. This condition, which can present in varying degrees of severity, may affect the shape and contour of the breast. Capsular contracture can occur unilaterally or bilaterally, often leading to dissatisfaction with the appearance of the breasts and, in some cases, discomfort or pain during physical activities or daily tasks.
When capsular contracture occurs, implant replacement is usually necessary to restore the shape and harmony of the surrounding tissue. Polyurethane-coated implants form a complex yet biocompatible interface with the surrounding tissue, preventing the rigid adhesions that typically develop over time between the implant and the body. This feature helps maintain the breast’s shape and aesthetic appearance for longer periods, as the implant adheres to both the pectoral muscle and breast tissue with minimal to no displacement.
Polyurethane-coated implants are generally placed in the subglandular plane—behind the mammary gland but in front of the muscle—since placing them behind the muscle could result in excessive adherence to the intercostal area. Internally, these implants contain silicone, just like standard implants. However, they are more expensive than smooth or microtextured implants due to the complex manufacturing process and the active patent protections held by companies such as SILIMED in Brazil and POLYTECH in Germany, both of which maintain high quality standards and traceability of their products (2).
In our practice, the use of polyurethane-coated implants in the subglandular plane has provided effective solutions for complex and challenging cases, resulting in full patient satisfaction and outcomes that exceed expectations (3).
References:
- 2020 Top 5 Cosmetic Surgical Procedures, www.plasticsurgery.org
- Polyurethane Breast Implants: The Perfect Breast Implant? Dr. Jorge Aso
- Private Practice Statistics by Dr. Manuel Peralta García, Plastic and Reconstructive Surgeon
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