Unusual and Late Complication of Polyurethane-Coated Prosthesis—Intraprosthetic Hematoma

Abstract

This case report deals with what we believe to be a previously unreported complication using the polyurethane-coated breast implants. Our patient presented with unilateral intraprosthetic breast prosthesis enlargement resulting in pain and excessive stretching of the skin. The focus of this study is to present the history, treatment, and possible explanations for the findings in this case.

Many have proposed the polyurethane-covered breast implants as the answer to the plaguing problems of contracture and firmness as well as recommending them for general use in augmentation mammoplasty. As use of the polyurethane-coated implants increases, there will no doubt be an increase in complications with these implants. In our experience of over 2 years with 60 patients, 120 implants total, with the Meme and Replicon implants, we have encountered only one major complication. Although nearly all of our patients have had satisfactory results, the one significant complication encountered was that of a unilateral, intraprosthetic enlargement 14 months postoperatively, resulting in intractable breast pain and excessive stretching of the skin. After failure at conservative therapy, surgery was required, and it was possible to examine the prosthesis and shed some light on the plausible causes of this phenomenon.