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Transitioning From Conventional Textured to Nanotextured Breast Implants: Our Early Experience and Modifications for Optimal Breast Augmentation Outcomes.

BACKGROUND
Nanotextured breast implants were hailed as an innovation that may address capsular contracture and breast implant-associated anaplastic large cell lymphoma. Plastic surgeons were intrigued by the sweet-spot between smooth and conventional textured implants.


OBJECTIVES
This study aimed to evaluate the introduction of nanotextured implants alongside conventional textured implants and to compare early complications.


METHODS
Patients who underwent breast augmentation from the introduction of nanotextured implants in our practice with at least one-year follow-up were selected for analysis. They were divided into nanotextured and conventional textured implant groups, and further divided into three chronological subgroups. Patient characteristics, implant specifications, operative factors, and complication rates were compared.


RESULTS
A total of 415 cases with mean follow-up of 26.9 weeks was identified. Of which, 38.8% used nanotextured implants and 61.2% used conventional textured implants. Use of nanotextured implants increased from 26.9% in period 1 to 54.5% in period 3. The complication rates for conventional textured group were 0.8% at one year and 3.5% on overall follow-up, with mostly capsular contractures. For the nanotextured group, they were 6.8% and 8.7%, respectively, and "bottoming-out" was most common. However, when analyzed across chronological subgroups, complication rates decreased for nanotextured implants by period 3.


CONCLUSION
A learning curve and associated complications are expected for early adopters of new implants. In our series, nanotextured implants were associated with higher complication rates at one-year and on overall follow-up. However, modifications in patient selection, intraoperative techniques, and postoperative care reduced complications as observed in the later period.