Long-Term Outcomes with Poly-4-Hydroxybutyrate (P4HB) in Aesthetic Breast Surgery – an International Retrospective Review
Poly-4-hydroxybutyrate (P4HB) is a component of human connective tissue, produced as a biocompatible polymer, and used in surgery. It is fully resorbable and utilized as a support scaffold in various surgical specialties, including cosmetic breast surgery. Despite its potential benefits, the lack of comprehensive long-term data on complication rates hinders widespread adoption. This multi-surgeon study aims to provide insights into the application, safety, and outcomes of P4HB in cosmetic breast surgery.
Methods/Technique
:A retrospective chart review was completed from the records of four surgeons. Inclusion criteria consisted of placement of P4HB during primary or revisionary cosmetic breast surgery. Descriptive statistics were used for data analysis.
Results/Complications
:The review encompassed 150 patients with an average follow-up of 15.6 months. Most patients had P4HB placed during primary breast surgery (n=114; 76%); primary procedures included augmentation-mastopexy (n=72), breast reduction (n=29), mastopexy (n=11), and primary augmentation (n=2). A subset (n=36; 24%) of patients had P4HB placed during a revision augmentation (implant exchange) with concurrent mastopexy; indications for revision included implant malposition (n=16), capsular contracture (n=13), implant site change (n=6), and soft tissue coverage (n=1). An implant was used in 109 patients with the average size of 295cc. An overall complication rate of 13% (n=20) was observed, the most common being delayed wound healing (n=11) and seroma (n=4).
Conclusion
:There is a defined role for the use of P4HB in both primary and revision aesthetic breast surgery; its use does not inherently increase the complication risk of a procedure.