title: Correction of breast contour deformities using polyurethane breast implant capsule in revisional breast surgery.
abstract: Surgeons are commonly confronted with breast contour deformities and defects that result from previous surgical interventions. These soft tissue deformities can be corrected by conventional reconstructive flap surgery using autologous tissue, but there can be donor site morbidity. Smaller volume replacement is possible using temporary fillers such as hyaluronic acid or polylactic acid, or by using 'permanent' fillers such as autologous fat, but large defects are notoriously difficult to fill and often the fillers resorb or migrate. The patient described in this case report had an exchange of polyurethane implant (PU) in the left breast and correction of a contralateral breast contour filling deformity. A left breast partial capsulectomy was performed after implant removal and the capsule graft was inserted into a predissected pocket where soft tissue augmentation was required. A biopsy from the PU capsule was reported to show a foreign body type giant cell reaction to PU material in a fibrous capsule, lined by synovial metaplasia. The post-operative result showed satisfactory soft tissue revolumisation. PU breast implant structured capsule has thus been used as filler to correct breast soft tissue deformity and contour defects. Clearly it may have a use in other anatomical sites.
authors.affiliation: Postgraduate Medical Institute, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, Essex CM11SQ, UK. mbassem@doctors.org.uk
authors.forename: Bassem M
authors.initials: BM
authors.lastname: Mossaad
authors.forename: James D
authors.initials: JD
authors.lastname: Frame
mesh_terms: D000368:Aged; D019928:Breast Implantation / Q000009:adverse effects* / Q000379:methods; D018427:Breast Implants / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D004954:Esthetics; D005260:Female; D005549:Foreign-Body Reaction / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008408:Mastectomy / Q000379:methods; D011140:Polyurethanes; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D011140:Polyurethanes