Study conducted by Dr. Paolo Montemurro, MD, published in Aesthetic Surgery Journal, March 28, 2024
Level of Evidence: 3
Summary of Key Findings:
The popularity and advantages of “nano-textured” implants may be overestimated. According to the latest EN ISO 14607:2018 classification, these “nano” implants are considered smooth implants. This study aimed to directly compare POLYTECH MESMO microtextured implants with Motiva Ergonomix breast implants, focusing on early complications, especially implant displacement, in aesthetic breast augmentation.
The study included 329 patients: 185 received a POLYTECH MESMO implant, and 144 received a Motiva Ergonomix implant. The average follow-up period was 8 months for both groups. Of the 42 women who reported at least one complication, 26 were from the Motiva group (p=0.13). The majority of complications were related to implant displacement, with “bottoming out” being the most common. Fifteen patients in the Motiva group experienced bottoming out, compared to none in the MESMO group (P<.001). Seven patients required reoperation, with a higher frequency in the Motiva group (4.2% vs. 0.5%; P=.046).
General Conclusion:
POLYTECH MESMO breast implants provide better and more predictable results. Motiva implants often have displacement issues, especially during the first year, and do not offer advantages in preventing other complications.
While “nano-textured” implants have not yet shown cases of BIA-ALCL, microtextured implants have been studied for years and have a proven safety profile. Although capsular contracture and BIA-ALCL are serious complications, displacement issues such as rotation, implant placement too high, and bottoming out are common in daily plastic surgery practice.
For this study, patients were operated on at two different centers in Sweden and Italy, with treatments conducted from January 2016 to December 2022. All patients had similar characteristics in terms of age, BMI, smoking habits, implant volume, etc. The average implant volume was 311cc in the MESMO group and 337cc in the Motiva group. Postoperatively, all patients wore a special supportive bra for 3 months, day and night. Most patients were seen by the treating surgeon at 1 week, 6 months, and 1 year.
No drains were used postoperatively, and the inframammary fold was reconstructed and fixed using the 4-layer technique. Most prostheses were placed submuscularly (dual plane): 166 patients in the MESMO group and 131 patients in the Motiva group. In the subglandular position: 32 patients in the MESMO group vs. 13 in the Motiva group. One hundred seventy-five patients received an anatomical MESMO implant, type Opticon, compared to 10 with a round implant. All Motiva implants were round, as the brand does not offer anatomical implants.
It is noteworthy that 15 patients in the Motiva group experienced bottoming out, compared to 0 in the MESMO group. Additionally, in this short follow-up period, 2 cases of capsular contracture were observed in the MESMO group compared to 3 in the Motiva group. The risk of implant displacement is 2.36 times higher in the Motiva group than in the MESMO group. The difference is mainly in the complication of bottoming out, where the implant descends and creates an unnatural bulge under the nipple. This is likely due to the fact that these implants form a very (too) thin capsule around the implant, preventing the body from securing it properly.
Key Takeaways from the Study:
- The problem of bottoming out (the second most common reason for reoperation) is not only related to a poorly executed surgical procedure but is also associated with the type of implant surface and texturing.
- Nano-textured implants behave in practice like smooth implants, as confirmed by the latest ISO standard. The issue of bottoming out not only appears after a short follow-up period of one year but can also occur after a longer period, even up to 24 months. MESMO (POLYTECH) implants appear to result in fewer complications and offer more predictable outcomes.
