Our Experience Using Round Nano-Surface Ergonomix Implants for Breast Reconstruction: A Single-Center Retrospective Study

Abstract Background Round nano-surface Ergonomix (Motiva, Establishment Labs; Alajuela, Costa Rica) implants were developed to address concerns regarding capsular contracture and textured anatomical breasts implants. Objectives The authors describe their early experience with Ergonomix implants in breast reconstruction. Methods The authors retrospectively reviewed the charts of 212 patients (321 breasts) who underwent breast reconstruction employing round nano-surface Ergonomix implants between June 2017 and December 2020. Patients were followed for at least 12 months postoperatively. Demographics, surgical data, and postoperative surgical outcomes were recorded. Postoperative physical well-being and satisfaction with the breasts and implant were evaluated with Breast-Q questionnaires. Results Of 211 patients, 75.4% had surgery due to cancer, and 24.6% underwent prophylactic surgery. Major complications occurred in 21 breasts (6.5%), of which 20 underwent revision operations. Reconstruction failed in 1 case (0.3%). Eleven breasts (3.4%) had minor complications. Immediate breast reconstruction, irradiated breasts, and smokers had higher rates of complications (P = 0.009, 0.02, 0.022, respectively). Rippling was more common in the pre-pectoral implant plane compared with sub-pectoral reconstruction (9% vs 1.2%, P = 0.001). Capsular contracture rate was 0.9% and occurred only in irradiated breasts. Implant malposition (inferiorly and laterally) occurred in 6.5% of the breasts, with no association between implant malposition and implant plane. Early follow-up demonstrated high patient satisfaction with the implant and breasts, and high scores in terms of patients’ physical well-being. Conclusions Breast reconstruction employing the round nano-surface Ergonomix implant yielded low complication rates and high patient satisfaction. The transition from macro-textured to nano-surface implants has operative implications requiring a learning curve and surgical adjustments. Level of Evidence: 4