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

[BACKGROUND] 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.

[OBJECTIVES] The aim of this study is to assess the stability of five implant types over a 12-month period using 3D image analysis.

[METHODS] 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.

[RESULTS] 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.

[CONCLUSIONS] 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.