title: Polyurethane foam-covered breast implants: a justified choice?
abstract: OBJECTIVE
  Even if the safety of the polyurethane prosthesis has been the subject of many studies and professional and public controversies. Nowadays, polyurethane covered implants are very popular in plastic surgery for the treatment of capsular contracture.
  
  
  METHODS
  We have identified 41 papers (1 is a communication of the FDA) by using search browsers such as Pubmed, Medline, and eMedicine. Eleven manuscripts have been used for an introduction, and the remaining thirty have been subdivided into three tables whose results have been summarized in three main chapters: (1) capsular formation and contracture, (2) complications, (3) biodegradation and cancer risk.
  
  
  RESULTS
  (1) The polyurethanic capsule is a well defined foreign body reaction characterized by synovial metaplasia, a thin layer of disarranged collagen fibers and a high vascularization. These features make possible a "young" capsule and a low occurrence of capsular contracture even over a long period (10 years); (2) the polyurethane implants may be difficult to remove but there is no evidence that they cause an increase in the other complications; (3) there is no evidence of polyurethane related cancer in long-term studies (after 5 years).
  
  
  CONCLUSIONS
  Polyurethane foam covered breast implants remain a valid choice for the treatment of capsular contracture even if it would be very useful to verify the ease of removal of the prosthesis and to continue investigations on biodegradation products.
authors.affiliation: Plastic Surgery Unit, School of Medicine, University of Padova, Padova, Italy. carlotsc@tin.it.
authors.forename: C
authors.initials: C
authors.lastname: Scarpa
authors.forename: G F
authors.initials: GF
authors.lastname: Borso
authors.forename: V
authors.initials: V
authors.lastname: Vindigni
authors.forename: F
authors.initials: F
authors.lastname: Bassetto
mesh_terms: D000818:Animals; D019928:Breast Implantation / Q000009:adverse effects*; D018427:Breast Implants / Q000009:adverse effects / Q000145:classification*; D003286:Contracture / Q000453:epidemiology; D005260:Female; D005549:Foreign-Body Reaction / Q000453:epidemiology; D006801:Humans; D011140:Polyurethanes / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology
chemical_list: D011140:Polyurethanes; C028279:polyurethane foam