Impact on capsule formation for three different types of implant surface tomography

Abstract

Although capsular contracture remains one of the major problems following silicone breast implantation, the associated mechanism has yet to be determined. This study thus aimed to investigate capsule formation and capsular contracture using three types of implants with different surface topographies in vivo. Three types of implants (i.e., smooth, macrotexture, and nanotexture) with different surface topographies were inserted in a total of 48 Wistar rats. After 4 and 12 weeks, the samples were analyzed via histological, immunohistochemical, and Western blot examination. To identify implant movement, the degree to which implant position changed was measured. And the surface topography was characterized using scanning electron microscopy. Hematoxylin–eosin staining showed that the nanotexture type implant promoted significant decreases in capsule thickness at 12 weeks (P < 0.05), while Masson trichrome staining showed decreased collagen fiber density with the same implant type. Immunohistochemical and Western blot examination revealed reduced fibrosis markers (myofibroblast, and transforming growth factor beta-1) in the nanotexture surface implant. Meanwhile, implant location evaluation found that the nanotexture and smooth surface implants had significantly increased movement (P < 0.05). The nanotexture surface implant had been found to reduce capsule formation given that it minimizes the effects of factors related to foreign body reaction.

Augmenting Breast Implant Research

“…In addition, the capsule formation around laboratory-made implants was found to be similar both qualitatively (capsule appearance) and quantitatively (capsule thickness) to previously published reports using industry-fabricated miniature implants. After 1-month in vivo, textured implants resulted in capsule tissue growing into the indented features of the implant, consistent with previously published reports that textured implants become stable in their position within the pocket as early as 28 days after placement, with capsule formation noted in as early as 1 to 2 weeks 8,10–16 …”

“…After 1-month in vivo, textured implants resulted in capsule tissue growing into the indented features of the implant, consistent with previously published reports that textured implants become stable in their position within the pocket as early as 28 days after placement, with capsule formation noted in as early as 1 to 2 weeks. 8,[10][11][12][13][14][15][16] While numerous preclinical breast implant studies have been conducted in rodent models showing accurate histologic correlation with human tissue, rodent models are limited in their translatability to human subjects due to their skin laxity, which can affect implant capsule formation. 8,12,13 To counteract rodent skin laxity and better mimic the tight surgical pocket created when placing a breast implant, fast-absorbing Polysorb sutures were used to secure both teardrop-shaped smooth and teardrop-shaped textured implants to the underlying soft tissue by passing sutures through 3 holes traversing the entirety of the implant periphery.…”

A multi-targeting bionanomatrix coating to reduce capsular contracture development on silicone implants

“…There have been several alternative preventative strategies that have been developed to combat capsular contracture development. One such strategy that has been shown to reduce capsular contracture is topographical modification [ 29 , 30 ]. Recently, textured implants such as macrotexture and nanotexture type implants have been developed to overcome the shortcomings of the widely used smooth type surface implants.…”

“…Recently, textured implants such as macrotexture and nanotexture type implants have been developed to overcome the shortcomings of the widely used smooth type surface implants. However, concerns have been raised about both topographical modifications; nanotexture surface implants shift from the implant location whereas macrotexture implants promote frequent inflammatory responses [ 30 ]. Moreover, it has been reported by the US Food and Drug Administration (FDA) that textured surface implants increase the risk of breast implant-associated lymphoma (BIA-ALCL) [ 31 , 32 ].…”