title: A simple method to inset and position polyurethane-covered breast implants.
abstract: BACKGROUND
  Polyurethane-covered breast implants have been used increasingly for cosmetic and revision breast surgery. The incision for insertion should be of minimal length and the placement of these implants in the pocket can be more difficult than that of conventional implants because of the highly adherent textured surface of the polyurethane external layer that grasps the surrounding tissues. The use of a sterile plastic insertion sleeve that is open on both sides is suggested by the manufacturer to overcome the friction between the polyurethane implant and the skin and surrounding tissues.
  
  
  METHODS
  A new method to facilitate polyurethane implant insertion and adjustment in all cases of primary breast augmentation and revision surgery is presented. After the implant, which is in the sleeve, is located in the pocket, the plastic sleeve is filled with saline and antibiotics so the solution lubricates the surface around the implant. The sleeve is then twisted so that the solution is squeezed inside the pocket while the sleeve itself is pulled back and removed.
  
  
  RESULTS
  Between 2010 and 2013, this method was used in 73 cases of primary augmentation and revision breast surgery without any complications.
  
  
  CONCLUSIONS
  The method described here allows for easier removal of the plastic sleeve during polyurethane implant insertion without any complications or evidence of implant migration or rotation at follow-up.
  
  
  METHODS
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authors.affiliation: Division of Plastic Reconstructive and Aesthetic Surgery, Clinica Villa Salaria, Rome, Italy.
authors.forename: Manuel Francisco
authors.initials: MF
authors.lastname: Castello
authors.forename: Sheng
authors.initials: S
authors.lastname: Han
authors.forename: Alessandro
authors.initials: A
authors.lastname: Silvestri
authors.forename: Luca
authors.initials: L
authors.lastname: Grassetti
authors.forename: Matteo
authors.initials: M
authors.lastname: Torresetti
authors.forename: Yi Xin
authors.initials: YX
authors.lastname: Zhang
authors.forename: Aurelia Trisliana
authors.initials: AT
authors.lastname: Perdanasari
authors.forename: Claudio
authors.initials: C
authors.lastname: Marcelli
authors.forename: Diego
authors.initials: D
authors.lastname: Gigliotti
authors.forename: Davide
authors.initials: D
authors.lastname: Lazzeri
mesh_terms: D000328:Adult; D019928:Breast Implantation / Q000009:adverse effects / Q000379:methods*; D018427:Breast Implants; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D011140:Polyurethanes; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000379:methods; D018570:Risk Assessment; D020034:Silicone Gels; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D011140:Polyurethanes; D020034:Silicone Gels