LONG-TERM RESULTS IN POSTMASTECTOMY BREAST RECONSTRUCTION WITH POLYURETHANE-COATED IMPLANTS

Background. Breast reconstruction after mastectomy supports physical and psychological recovery in breast cancer patients. While implant- based procedures are common, capsular contracture (CC) remains frequent, causing firmness, pain, and aesthetic problems. Polyurethane-coated implants were introduced to reduce CC risk by minimizing fibrous capsule formation. This retrospective study examines CC incidence in patients reconstructed with polyurethane-coated implants, with a minimum of five years’ follow-up. Methods. A retrospective study was conducted on patients who underwent breast reconstruction using polyurethane-coated implants from 2013 to 2018. Thirty-seven reconstructions were included, with follow-up durations ranging from 6 to 11 years (mean 8.5 years). Patients underwent either prepectoral or submuscular implant placement. Additionally, the impact of postmastectomy radiation therapy (PMRT) on CC incidence was assessed by comparing irradiated and non-irradiated cases.Results. The overall incidence of CC was 35.1%. Stratification revealed higher rates in irradiated patients (75%) compared to non-irradiated patients (25%) [p = 0.001762]. Submuscular placement showed a lower incidence of CC (23.8%) compared to prepectoral placement (37%) [p = 0.007433]. Most cases of CC were classified as Baker grades II and III, indicating mild to moderate severity. Conclusions. Polyurethane-coated implants are associated with a reduced incidence of capsular contracture in the initial years following surgery. However, as the polyurethane coating degrades, the risk of CC increases, potentially reaching levels comparable to other implant types. Further long-term studies are necessary to validate these findings and to explore strategies for sustaining the benefits of polyurethane coatings in breast reconstruction.