Silicone Breast Implant Coated with Triamcinolone Inhibited Breast-Implant-Induced Fibrosis in a Porcine Model

Abstract

Cosmetic silicone implants for breast reconstruction often lead to medical complications, such as abnormally excessive fibrosis driven by foreign body granulomatous inflammation. The purpose of this study was to develop a silicone breast implant capable of local and controlled release of a glucocorticoid drug triamcinolone acetonide (TA) for the prevention of silicone-breast-implant-induced fibrosis in a Yorkshire pig model (in vivo). Implants were dip-coated in a TA solution to load 1.85 μg/cm2 of TA in the implant shell, which could release the drug in a sustained manner for over 50 days. Immunohistochemical analysis for 12 weeks showed a decline in tumor necrosis factor-α expression, capsule thickness, and collagen density by 82.2%, 55.2%, and 32.3%, respectively. Furthermore, the counts of fibroblasts, macrophages, and myofibroblasts in the TA-coated implants were drastically reduced by 57.78%, 48.8%, and 64.02%, respectively. The TA-coated implants also lowered the expression of vimentin and α-smooth muscle actin proteins, the major profibrotic fibroblast and myofibroblast markers, respectively. Our findings suggest that TA-coated silicone breast implants can be a promising strategy for safely preventing fibrosis around the implants.

A Histological Evaluation of the Efficiency of Using Periprosthetic Autologous Fat to Prevent Capsular Contracture Compared to Other Known Methods—An Experimental Study

“…The purely infectious etiology of capsular contracture is questioned by the reporting of positive bacterial cultures in peri-implant capsules in patients without capsular contracture. Other preventive and risk-reduction methods for capsular contracture are mentioned in the literature, including the use of steroids and immunomodulators to combat inflammation [ 45 , 46 ].…”

“…Local steroids have been used in the past to suppress capsular contracture [ 46 ]. They were introduced directly into the pocket or into an inflatable or double-lumen implant [ 47 , 48 ].…”

Melanocortin therapies to resolve fibroblast-mediated diseases

“…Then, preventing the crosstalk, i.e., intercepting the messenger, early in the pathogenic process may be a useful strategy. For example, by pre-coating implants using potent anti-inflammatory drugs like steroids, fibrotic encapsulation could be prevented ( 122 , 123 ), although the use of corticoids may increase the risk of infections. In addition, this strategy can only be applied in situations when the time of initiation of the fibrotic cascade is known.…”

Microchannel-embedded implantable device with fibrosis suppression for prolonged controlled drug delivery

“…Transforming growth factor-β (TGF-β) is a cytokine secreted during wound healing, and a high expression of TGF-β is closely related to abnormally high fibrosis around an implanted device (Ward, 2008 ; Meng et al., 2016 ; Nam et al., 2021 ). Tranilast (TR) is a drug for inhibiting TGF-β; thus, it has often been prescribed for the treatment of pathological fibrotic diseases in clinical settings (Holmes et al., 2000 ; Singh et al., 2004 ).…”