Immediate breast reconstruction with Polyurethane-Coated implants following mastectomy: Early experience and short-term outcomes

Immediate breast reconstruction (IBR) with implants has become an essential component of post-mastectomy treatment, significantly improving patient's quality of life. Traditionally, submuscular implant placement has been used but may cause pain and functional limitations. Prepectoral approach, using biological acellular dermal matrices or synthetic meshes, is an option but has been associated with increased complication rates and higher healthcare costs. Prepectoral reconstruction with polyurethane-coated implants is an alternative that reduces morbidity and enhances esthetic outcomes. This retrospective study analyzes patients undergoing direct-to-implant (DTI) reconstruction with polyurethane-coated implants (Microthane®) after nipple-sparing (NSM) or skin-sparing mastectomy (SSM) (January 2024–January 2025). Clinical, histological, surgical, and postoperative outcomes were reviewed. A total of 22 prepectoral DTI procedures were performed. The overall success rate was 95.5%. The mean age was 45.7 years, while the mean BMI was 26.3. Most patients (77.3%) were premenopausal. NSM was performed in 63.6% of cases. The mean hospital stay was 4.4 days. Complication rates were low, with 4.5% of patients developing seroma, 9.1% hematoma, and 9.1% red breast syndrome. One patient (4.5%) experienced implant loss. No capsular contracture was observed. Prepectoral IBR with polyurethane-coated implants is safe and effective, with low complication rates and excellent esthetic outcomes. It represents a viable, safe and feasible alternative, reducing morbidity and improving patient outcomes. Further studies are needed to assess long-term outcomes and confirm its benefits. Graphical abstract