Implants and expanders

Why is taking accurate measurements more important than choosing a volume?

Most patients open the conversation with "how many cc?" From a surgical standpoint, that is the last question to ask. If the implant's base width does not match the natural width of the chest wall, no volume can rescue the result: the implant edges become visible, a "wing" effect appears at the sides, or the tissue is overstretched. That is why the POLYTECH selection system starts with measurements — chest wall width, existing tissue thickness (pinch test), and skin elasticity.

The second step is choosing the primary shape. POLYTECH SublimeLine offers four base shapes — this breadth of choice allows the selection to be tailored to the specific anatomy and goal.

The practical difference between the shapes

• Même® — the classic round shape: a circular base with an evenly convex profile. It gives a fuller look in the upper pole, and rotation is not a concern, because rotation has no visible effect on the result.
• Replicon® — the classic among anatomical shapes: a teardrop profile with more volume in the lower pole. It reproduces the breast's natural slope.
• Opticon® Plus — a shortened base with a soft upper-edge transition: a suitable choice when excessive upper-pole fullness is not desired.
• Opticon® — the shortest base; can be a suitable choice for patients with abundant subcutaneous fat in the upper breast.

The third step is projection: the maximum distance from the implant's base to its forward-most point. POLYTECH manufactures breast implants in four projection levels: low, moderate, high, and extra high. The practical rule is simple: at the same volume, a higher projection looks "fuller" and narrower, while a lower projection creates a "wider," more spread-out appearance.

Diagon\Gel® 4Two — two gels in one implant

A distinctive solution: the rear of the implant contains a softer EasyFit Gel™ (which conforms to the rib cage), and the front a firmer Shapar Gel™ (which keeps the projection stable). As a result, the implant settles into the anatomy at the back while holding its shape at the front. It is available in two versions: 4Two AR (anatomical-round) and 4Two AO (anatomical-oval, with a shortened upper contact area).

Implant sizing cannot be done from a photograph. We support healthcare professionals with sizer sets and the POLYTECHselect catalog — write to us to clarify the terms of sizer use.

Capsular contracture is the hardening and tightening of the connective-tissue capsule that naturally forms around an implant. The cells driving this process are myofibroblasts — their activity is measured by the marker α-SMA (alpha-smooth muscle actin). The more α-SMA, the greater the potential for contraction and contracture.

Study design

B. Cagli and co-authors (Plastic and Reconstructive Surgery, 2023) randomized 30 reconstruction patients into five expander groups with different surfaces: smooth, polyurethane foam, low-microtextured, high-microtextured, and macrotextured. The capsules removed at implant exchange were compared for morphology and the markers α-SMA, collagen I/III, CD68, CD34, and CD3.

Results

α-SMA levels in the capsules around the smooth surface were statistically significantly higher than in the polyurethane (p=0.007), low-microtextured (p=0.010), and high-microtextured (p=0.028) groups. The authors interpret this as follows: tissue remodeling around polyurethane and low microtexture proceeds with less myofibroblast activation, less inflammation, and less neoangiogenesis — in other words, conditions that favor the formation of a less fibrotic capsule.

The POLYTECH portfolio includes precisely these two surfaces: MESMO® (microtexture) and Microthane®* (polyurethane). In other words, the clinical observations (Montemurro) and the mechanism study (Cagli) point in the same direction.

Limitation

This is a mechanism study of 30 patients and does not directly measure clinical endpoints (long-term contracture rates).

The problem: implant weight makes itself felt over time

Once an implant is placed, its weight acts on the tissue every day, for years. When a large-volume implant meets thin-skinned tissue, the possible consequences are predictable: lower-pole stretching, recurrent sagging (ptosis), and sometimes displacement of the inframammary fold (IMF). This is a result of physics, not surgical technique.

The solution: microbubbles inside the gel

In B-Lite® implants, hollow microspheres are added to standard implant-grade silicone gel. As a result, an implant of the same size and shape is about 30% lighter. According to the manufacturer, these microspheres withstand pressures above 200 psi and remain bound to the gel; similar microsphere technology is already used in urology, oncology, and orthopedics.

A practical measure: according to POLYTECH's technical data, a B-Lite® implant exerts about as much pressure on the tissue as a conventional implant roughly half its volume.

Clinical results — 5-year data

The study by Govrin-Yehudain and co-authors published in Aesthetic Surgery Journal covers 827 patients (1653 implants), with follow-up of up to 5.6 years. Results: 5-year risk of capsular contracture (Baker III) was 0.6%; no ruptures were recorded; 97.1% of patients needed no reoperation within 5 years. 94.9% of patients rated the aesthetic result, and 95.5% the natural look and feel, at 4–5 on a 5-point scale. No cases of BIA-ALCL (lymphoma) or recurrent ptosis were recorded at all.

Imaging compatibility

According to the manufacturer's current instructions for use, B-Lite® is compatible with MRI examination, is more radiolucent than silicone on mammography, and the shell contour is more clearly visible on ultrasound. It should be noted that these characteristics are based on the manufacturer's own data.

B-Lite® is particularly suitable in the following situations: for patients with an active lifestyle, when a large volume is planned, when the skin is thin or poorly elastic, after massive weight loss, in combination with mastopexy, and in reconstruction.

What we are not promising

The physics is clear: less mass at the same volume means less force on the tissue. But there is not yet a randomized comparative study proving that this translates into less sagging or fewer reoperations after 5 years — the available studies are single-arm and non-randomized. That is why we present B-Lite® not as "prevents sagging" but as "measurably reduces the load on the tissue".

Polyurethane-covered implants date back to the 1970s, and their advantage in capsular contracture has long been observed. The withdrawal of polyurethane implants from the US market in 1991 is described in the literature of the period as a commercial decision; the FDA's subsequent assessment characterized the cancer risk associated with the polyurethane covering as "low, if any."

Current data

A study published in JPRAS Open in 2025 covers 143 consecutive patients who underwent direct-to-implant reconstruction after mastectomy (in the prepectoral position, without additional matrix material). Median follow-up was 4.5 years.

Capsular contracture (Baker III/IV) was recorded in 13 patients (9.1%). The radiation therapy factor stands out clearly: contracture occurred in 18.6% of irradiated patients versus 5.0% of those not irradiated (p=0.0215); overall complications were 30.2% and 14.0%, respectively (p=0.0229).

The authors' conclusion: prepectoral Microthane®* reconstruction shows "a low contracture rate and high patient satisfaction, including in patients receiving radiation therapy." In this protocol, no additional matrix material was used — the authors note this as an advantage in terms of surgical simplicity and cost; the study does not prove that the need for a matrix is eliminated in other protocols.

Note: in the ISO 14607:2024 classification, polyurethane-covered implants fall into a separate ("covered surface") category. The choice always rests on the surgeon's clinical judgment.

All POLYTECH implants are manufactured in Germany, at the company's own plant in Dieburg, and each undergoes individual inspection before release to the market. This is a different model from subcontracted manufacturing, and it means all key stages of production remain under one company's control.

Practical steps for the patient

• After surgery, ask your clinic or surgeon for the implant's serial number and documentation. Keep the documents — you will need them for the warranty and future examinations.
• Register in the manufacturer's warranty program within 6 months of surgery (the patient must complete the registration personally).
• Keep to the follow-up schedule set by your surgeon; monitoring with MRI or ultrasound is performed at the surgeon's recommendation.
• If you notice a change in breast shape, firmness, or pain, contact your surgeon without delay.

On the platform, every unit is registered, the documentation package is provided at handover, and configurations not in stock are brought in to order within 1–2 months.