Comparison of Formation of Capsule Among Different Breast Silicone Implants

Abstract

Background/Aim: Silicone implants are widely used biomaterials in surgeries owing to their physiological inertness and low toxicity. However, capsular contracture is a severe complication caused by the insertion of breast implants, which can endanger the health of patients. In this study, twelve different silicone breast implants were tested to determine which could lead to a lower incidence of capsular contracture. Materials and Methods: For in vivo experiments, these silicone implants were implanted into 60 rats (i.e., five implants per rat). The implants were explanted eight weeks after the operation. Samples were analyzed and measured by using hematoxylin and eosin staining, Masson's trichrome staining, and immunofluorescence staining methods. We compared twelve samples for their differences in the thickness of capsular formation, number of inflammatory cells, collagen expression, fibroblast intensity (i.e., Vimentin and α-SMA), and inflammatory cytokines (i.e., IL-8, CD68, MCP-1, and F4/80). Results: Different surface textures of breast implants gave different effects on capsular thickness, collagen formation, fibroblast formation, and potential inflammation. Samples that had smooth textures such as SEBBIN, HANS, and Mentor showed higher collagen formation than other samples. SEBBIN Texture, Motiva Micro, HANS Smooth I, and HANS Micro exhibited higher fibroblast formation (i.e., α-SMA, Vimentin). SEBBIN Smooth and samples in HANS group displayed lower expression of inflammation cytokines (IL-8, CD68, MCP-1, and F4/80). Conclusion: These findings provide preliminary reports on the surface texture effect and support a selection of breast silicone implants in breast reconstruction to avoid the formation of capsular contracture after implantation.

Augmenting Breast Implant Research

“…4F–I). These morphological characteristics are consistent with previously published histology of industry-produced miniature smooth and textured silicone devices implanted in rats 8,9 . Capsule thickness of smooth implants was unchanged between 1 and 3 months (429.3 ± 121 and 414.4 ± 107 μm, respectively, P > 0.05).…”

“…Although some prior studies in both rats and rabbits, as well as the current one, have found that textured implants may induce a thicker capsule compared with smooth implants, this is opposite to many clinical studies, which have demonstrated that textured implants induce thinner capsules. 9,[17][18][19] Another important limitation in this study is the use of semirigid implants that do not completely mimic the rigidity of commercially available breast implants. Although PDMS is a suitable material for pilot studies due to its low cost, ease of use, and chemical and physical tunability, its properties are different from the silicone used to fill breast implants.…”

“…These morphological characteristics are consistent with previously published histology of industry-produced miniature smooth and textured silicone devices implanted in rats. 8,9 Capsule thickness of smooth implants was unchanged between 1 and 3 months (429.3 ± 121 and 414.4 ± 107 μm, respectively, P > 0.05). In contrast, the capsule thicknesses for salt-textured implants increased between 1 and 3 months (368.5 ± 103.1 to 632.0 ± 244.3 μm, P > 0.05; Fig.…”

Is It All about Surface Topography? An Intra-Individual Clinical Outcome Analysis of Two Different Implant Surfaces in Breast Reconstruction

“…Therefore, currently, microtextured tissue expanders are widely used, but also within this group surface roughness may vary widely. Zhang et al showed an increase in collagen formation and fibroblast formation but a decreasing expression of inflammation cytokines with higher surface roughness in the capsule surrounding the implant in a rat model [ 57 ]. In a previous approach, we investigated the immune response of human peripheral blood mononuclear cells (PBMC) to commercially available silicone surfaces (breast implant surfaces) in vitro and could demonstrate that a decrease in surface topography reduces adherent immune cells and fibrosis-associated cytokine gene expression [ 46 ].…”

Is it all about Surface Topography? An Intraindividual Clinical Outcome Analysis of Two Different Implant Surfaces in Breast Reconstruction

“…Therefore, currently, microtextured tissue expanders are widely used, but also within this group surface roughness may vary widely. Zhang et al showed an increase in collagen formation and fibroblast formation but a decreasing expression of inflammation cytokines with higher surface roughness in the capsule surrounding the implant in a rat model [59]. In a previous approach, we investigated the immune response of human peripheral blood mononuclear cells (PBMC) to commercially available silicone surfaces (breast implant surfaces) in vitro and could demonstrate that a decrease in surface topography reduces adherent immune cells and fibrosis-associated cytokine gene expression [46].…”