Dynamic Behavior of Breast Implants: A One-year Prospective Three-dimensional Analysis.

Abstract

The dynamic interaction between breast implants and tissues influences long-term aesthetic outcomes after augmentation mammaplasty. Implant characteristics such as shape, gel cohesivity and surface texture may affect postoperative results. The aim of this study is to assess the stability of five implant types over a 12-month period using 3D image analysis. A prospective single-surgeon study was conducted on 106 patients (212 breasts) undergoing primary breast augmentation. Five implant types were evaluated: smooth progressive gel ULTIMA (PgU) round, smooth high-strength cohesivity gel (HSC+) round, microtextured round, microtextured anatomical, and polyurethane (PU)-coated anatomical. 3D morphometric analysis (using Arbrea® software) measured nipple-to-inframammary fold distance (N-IMF) and lower pole ratio (LPR) at 6 and 12 months. Statistical associations between implant type, volume, and elongation were analyzed; complication and satisfaction rates were compared across groups. Smooth PgU round implants demonstrated the greatest elongation (Δ N-IMF: 0.98 ± 0.26 cm; Δ LPR: 6.84 ± 3.02 p.p.), whereas PU anatomical implants showed negligible change (Δ N-IMF: 0.04 ± 0.35 cm; Δ LPR: 0.46 ± 2.75 p.p.) (p < 0.001). Implant type and volume were significantly associated with elongation (p < 0.0001 and p < 0.05, respectively). The overall complication-per-implant rate was 2.4%, predominantly among smooth PgU implants (p = 0.011). Patient satisfaction was high and comparable across groups. Implant gel cohesivity, surface texture and volume affect implant stability. PU-coated anatomical implants showed the least change, whereas smooth groups presented the highest elongation and complication rate.