Extract

I am delighted to comment upon the reply1 to my Commentary2 on the article by Pompei et al published in the Aesthetic Surgery Journal.3 Despite the journal’s invitation to Pompei et al to reply to my Commentary, they have not actually addressed many of the issues that I had raised and if they are writing an article with a generic title they must consider all manufacturers of modern polyurethane implants. I stand by my Commentary and their limited reply confirms that my comments were correct.

They quite rightly reiterate that the silicone elastomer component of polyurethane implants is different from the first generation elastomers, but I had commented that the polyurethane layer pore size and thickness is not different and most surgeons are aware that it is the polyurethane layer and not the elastomer that differs polyurethane implant outcomes from silicone implants outcomes. The integrity of the silicone elastomer within first or “modern” polyurethane implants has not previously been questioned. In addition, there are no randomized trials comparing rupture rates between prosthesis.

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