ArticleThe British journal of surgery2025
Comparison of revision surgery after implant-based breast reconstruction between smooth, textured, and polyurethane-covered implants: results from the Dutch Breast Implant Registry.
Article in The British journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Changing Paradigms in Polyurethane-coated Breast Implant Surgery: A Bibliometric Analysis of 4 Decades of Clinical Practice.Plastic and reconstructive surgery. Global open · 2026Article
- Capsular Contracture in Implant-Based Breast Reconstruction: A Comprehensive Narrative Review of Pathophysiology, Risk Factors, and Contemporary Controversies.Medicina (Kaunas, Lithuania) · 2026Review
- Microbial Contamination-Mediated Inflammation Is a Major Contributor of Breast Implant Complications: Prospective Analysis of 631 Samples.Journal of clinical medicine · 2026Article
- Toward Successful International Pooling of Breast Implant Registry Data: The Role of Dataset Uniformity.Aesthetic surgery journal. Open forum · 2026Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImplant-based breast reconstruction is the most common technique after mastectomy. Breast implants are categorized by surface type as smooth, textured, or polyurethane-covered, each with specific attributed advantages and complication profiles. High-quality comparative studies are, however, limited. This study compared revision incidence and indications for revision among these implant types.
methodsA prospective, nationwide cohort from the Dutch Breast Implant Registry was analysed. Permanent implants used between 2017 and 2022 for direct-to-implant or two-stage reconstruction were included. Surface-related revision was the primary outcome. Cumulative incidences were estimated using a competing risk model. Cause-specific hazard ratios (HRcs) were calculated using univariable and multivariable models, accounting for implant clustering and confounders. Subgroup analyses examined revisions for specific complications.
resultsOf 3996 implants, 76.9% were textured, 12.4% smooth, and 10.8% polyurethane-covered. At 4 years, the cumulative incidence of revision surgeries did not differ between textured (11.1%; 95% c.i. = 9.9 to 12.5), smooth (13.0%; 95% c.i. = 8.5 to 18.4), and polyurethane-covered (16.1%; 95% c.i. = 12.4 to 20.2) implants. Multivariable analysis found no association between surface type and surface-related revision. Subgroup analysis however revealed that polyurethane-covered implants had increased hazards of revision for capsular contracture (HRcs = 2.49; 95% c.i. = 1.24 to 5.01) and asymmetry (HRcs = 2.31; 95% c.i. = 1.33 to 4.02).
conclusionAfter adjusting for confounders and clustering, surface-related revision in a reconstructive setting did not significantly different among breast implant surface types overall. Polyurethane-covered implants may, however, require more revisions due to capsular contracture and asymmetry.
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