Polyurethane breast implants, also known as furry Brazilian or hairy German implants, are gaining popularity amongst patients and doctors due to some of the benefits they have. It must be remembered that all procedures and all new treatments have advantages but also disadvantages.
The advantages of polyurethane are:
1. A reported lower rate of capsular contracture. This is where the capsule that covers the breast implant and holds it in place becomes very tight. There are 4 degrees of capsular contracture with the fourth being very tight very hard, calcified, painful and even an apparent blue colour of the skin. The rates of capsular contracture vary with the average being approximately 4%. Some clinics run up to 14%. At Absolute Cosmetic our rate of capsular contracture is less than 1% and we believe this is due to the use of tumescent fluid which reduces the bleeding and the limited use of diathermy for burning to stop blood vessel bleeding. The cause of capsular contracture is not known. The furry Brazilian implants have a rate of less than 1%.
2. The polyurethane holds the implant in place, which is beneficial for the more saggy breast. Sagginess or ptosis is extremely unpredictable in some breasts, and where the capsule can go hard, it can also unexpectedly go lax and cause floppiness. Some of the newer implants are made in a conical shape, which means their curved radius is longer and can fit the saggier breast to a greater degree.
The disadvantages of polyurethane are:
1. Although the implant being sticky and having the ability to hold the breast in place, it is seen as a disadvantage as it can give a more stuck on appearance. Whereas the average implant takes between 3 months and a year to settle and soften, the polyurethane implant can take longer and can ride higher. When inserting the implant, the patient must be aware that these sticky implants can ride higher for longer. Indeed during placement, the patient is sat up on the table to ensure the implant is not too high as this will persist. Some patients need massage and compression to bring these down and into place. The doctor’s orders must be closely followed so that the implant does not stay high for an extended period of time. Often one implant will be slower to descend than the other, but it must be remembered that asymmetry in breasts is very common.
2. The polyurethane covering these implants makes it very difficult to get the implants removed in under six months as it acts like Velcro until the polyurethane softens and dissolves into the capsule.
3. Some people will have a short-term allergic rash to the polyurethane and antihistamines must be used.
4. Because the implant is sticky, rippling and edges may be felt for a longer period of time until the polyurethane dissolves into the capsule.
5. There is some concern that the polyurethane may leach into the system, although this has not been proven in any long-term studies.
Conclusion
Polyurethane implants have their advantages and disadvantages, with the advantages in the right patient far outweighing the latter.
Floppiness, or ptosis in the breast, is extremely unpredictable and, in some studies, ranges up to 16%, and these implants can be seen as useful in partially preventing this.
