Polyurethane-coated silicone breast implants: A viable option for primary augmentation mammoplasty: A systematic review and technical considerations

Background: Breast augmentation has evolved significantly since its inception in the 1960s, with polyurethane (PU)-coated breast implants emerging as a notable innovation in the 1970s. Despite their potential advantages in reducing capsular contracture, concerns persist among surgeons regarding their safety and technical challenges, particularly in primary augmentation mammoplasty. The aim of this study was to highlight the numerous advantages and safety of PU implants, promoting them as a viable option for primary augmentation mammoplasty. Methods: The authors experience documented in the form of a case series was combined with a systematic review that examined the safety and efficacy of PU-coated breast implants for primary augmentation mammoplasty. A case series involving 50 patients who underwent this procedure from January 2023 to January 2024 is reported. Additionally, a comprehensive literature review from 2000 to 2023, using the PubMed, CINAHL, EMBASE, and Scopus databases, along with clinical experience and case reports were conducted according to the preferred reporting items for systematic reviews and meta-analyses guidelines. Results: Studies indicate a low risk of malignancy associated with PU-coated implants, with no evidence of free 2,4-toluenediamine in the serum samples. A nearly nonexistent occurrence of capsular contracture, along with minimal surgical complexities make it an excellent choice for achieving functional and aesthetic results. Conclusion: PU-coated breast implants demonstrate equivalence to standard textured implants for primary augmentation mammoplasty, with advantages including reduced capsular contracture rates and improved stability. Despite historical skepticism, evidence supports their safety and effectiveness, positioning them as a viable option in breast augmentation surgery. Implementation of appropriate surgical techniques is paramount to optimizing outcomes and ensuring patient satisfaction.