title: Benefits and Limitations of Macrotextured Breast Implants and Consensus Recommendations for Optimizing Their Effectiveness.
abstract: Implant texture is an important factor influencing implant selection for breast augmentation. Natrelle Biocell implants are characterized by macrotextured shell surfaces containing irregularly arranged concavities with large open-pore diameters and depths. These properties facilitate adhesion of the implant to the surrounding tissue, thereby promoting implant immobilization. Relative to implants with other surfaces, macrotextured implants offer low rates of capsular contracture; low rates of malposition, rotation, and rippling; and high rates of patient satisfaction. However, macrotextured implants are associated with a slightly higher risk of double capsule and late seroma. The surgeon can minimize these risks with straightforward techniques that encourage tissue adhesion. This report presents experience-based recommendations to optimize the effectiveness of Biocell anatomic implants. The authors discuss the application of best practices to all aspects of the breast implantation process, from implant selection and surgical planning to operative technique and postoperative management. LEVEL OF EVIDENCE 3.
authors.affiliation: Dr Maxwell is a Clinical Professor of Plastic Surgery at the Loma Linda School of Medicine, Loma Linda, California gpm@maxwellaesthetics.com.
authors.forename: G Patrick
authors.initials: GP
authors.lastname: Maxwell
authors.affiliation: Dr Scheflan is a plastic surgeon in private practice in Tel Aviv, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Scheflan
authors.affiliation: Dr Spear is a Professor and Chairman of the Department of Plastic Surgery, Georgetown University Hospital, Washington, DC.
authors.forename: Scott
authors.initials: S
authors.lastname: Spear
authors.affiliation: Dr Nava is a plastic surgeon and Head of the Plastic Unit, IRCCS Foundation, National Cancer Institute, Milan, Italy.
authors.forename: Maurizio B
authors.initials: MB
authors.lastname: Nava
authors.affiliation: Dr Hedén is an Associate Professor of Plastic Surgery at Akademikliniken, Stockholm, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Hedén
mesh_terms: D019985:Benchmarking; D019928:Breast Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000592:standards; D018427:Breast Implants; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D057910:Implant Capsular Contracture / Q000209:etiology / Q000517:prevention & control; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D011474:Prosthesis Design; D012307:Risk Factors; D013499:Surface Properties; D000267:Tissue Adhesions; D016896:Treatment Outcome
keywords: breast augmentation; double capsule; macrotextured implants; seroma