Polyurethane Ruptured Breast Implants
Polyurethane breast implants are coated with polyurethane foam and filled with silicone gel. These implants were created in the 1970s because the coating was found to pose minimal risk of capsular contracture. However, studies found that the biodegradation of the polyurethane shell released carcinogenic breakdown products, prompting the discontinued use of these implants in the United States. While these are not commonly used anymore, there are patients with polyurethane implants who experience complications that necessitate revision surgery. Many patients are asymptomatic and must undergo regular MRI testing to assess the integrity of their implants and check for signs of failure. As with other types of breast implants, polyurethane implant rupture can occur due to several factors, including:
- Damage during surgery
- Blunt trauma or blow to the chest
- Biodegradation of the implant shell over time
- Mechanical pressure (i.e., mammogram or ultrasound)
Symptoms of Ruptured Polyurethane Implants
Much like traditional silicone implants, when polyurethane implants rupture, the patient often does not experience alarming symptoms. Initially, a rupture can cause slight silicone gel leakage, which can be undetectable at first. Significant damage to the implant may result in noticeable changes in breast appearance or sensation. Some potential symptoms of polyurethane implant rupture include:
- Breast pain or tenderness
- Swelling or redness
- Hardening of the breasts (capsular contracture)
- Visible distortion of the breasts
- Formation of granulomas
Diagnosis of Polyurethane Implant Rupture
Polyurethane implants are known to have a lowered risk of complications, such as rupture and capsular contracture, than many other implant types. Patients with any type of silicone implants are advised to schedule MRI appointments every other year or so to detect signs of implant failure early. Other diagnostic methods may show indications of implant failure, but MRI testing is the most reliable. An initial evaluation by a board-certified plastic surgeon may help to diagnose visible or tactile complications, but these issues would likely require further testing for an accurate assessment.
Implant failure, regardless of the type of prosthesis used during the initial breast augmentation, requires immediate surgical attention. Tending to polyurethane implant rupture can deliver the best result and preserve the breast pocket. Depending on the patient’s needs, she may qualify for capsulectomy, capsulotomy, breast revision, or explanation. Calcified granulomas and traces of silicone gel must be removed during any of these procedures.