The Relationship of Bacterial Biofilms and Capsular Contracture in Breast Implants

Abstract

Capsular contracture is a common sequelae of implant-based breast augmentation. Despite its prevalence, the etiology of capsular contracture remains controversial. Numerous studies have identified microbial biofilms on various implantable materials, including breast implants. Furthermore, biofilms have been implicated in subclinical infections associated with other surgical implants. In this review, we discuss microbial biofilms as a potential etiology of capsular contracture. The review also outlines the key diagnostic modalities available to identify the possible infectious agents found in biofilm, as well as available preventative and treatment measures.

Open Capsulotomy: An Effective but Overlooked Treatment for Capsular Contracture after Breast Augmentation

“…Another theory for capsular contracture is based on the mechanical action of myofibroblasts 1,7,9,43,46,47 and abnormal collagen deposition. 9,42,43 A capsulotomy breaks this mechanical force.…”

“…9,42,43 A capsulotomy breaks this mechanical force. 7 It is possible, although unproven, that nonpathogenic bacteria may be protective against pathogens 38 (similar to the flora of the digestive tract) and attempts to alter the microbial environment with antibiotics may be counterproductive.…”

“…1–9 The “gold standard” treatment calls for a capsulectomy, along with a site change and implant exchange. 2,7,9 However, Wan and Rohrich, 7 in a recent systematic review, found little supportive evidence for this recommendation. Recurrence rates after surgical treatment are sparsely reported.…”

Mechanisms of Breast Implant Toxicity: Will the Real Ringmaster Please Stand Up

“…Aerobic and anaerobic bacteria in the soil degrade organosilicon compounds into molecules of silica (silicon dioxide), silicic acid, silanols, water, and carbon dioxide (13) . It is now known that normal breast tissue is not sterile (14,15) . The diversity of bacteria that are present will routinely colonize the outside and inside of implants once they are inserted into the body (14) , whereupon the same degradation processes are initiated (13) .…”

“…It is now known that normal breast tissue is not sterile (14,15) . The diversity of bacteria that are present will routinely colonize the outside and inside of implants once they are inserted into the body (14) , whereupon the same degradation processes are initiated (13) . These processes are augmented by hydrolases released by macrophages, which are also present in abundance outside and inside these devices (8) .…”