Breast reconstruction: differences in outcome between two types of breast implants?

Two-stage implant-based breast reconstruction is the most common reconstructive technique after mastectomy. It is associated with some implant specific complications such as capsular contracture. Capsular contracture is one of the most frequent long-term complications which develops when the capsule surrounding the implant, which always develops as a result of a normal foreign body reaction, becomes constricted and tight, resulting in malposition of the implant, a firm and/or painful breast and deterioration of the aesthetic result, which may require reoperation. On average one out of every six implant breast reconstruction patients will develop a capsular contracture after 10 years. Much of the etiology is still unknown, but a relationship between the outer surface of the implant and the chance of developing capsular contracture has been suggested . For example, compared to smooth implants, textured implants have shown to result in lower capsular contracture rates. Based on the current literature, which comprises of retrospective cohort studies and case-series, we hypothesize that polyurethane-covered implants reduce or delay the development of capsular contracture compared to textured implants.

Surgery - 2 weeks post-op - 6 months post-op - yearly from 1 year post-op until 10 years post-op.

Patients in both cohorts will receive a two-stage implant-based breast reconstruction after mastectomy. In the second stage, the intervention cohort will receive a polyurethane covered silicone implant and the control cohort will receive a standard textured silicone implant.