Capsule formation around breast implants

Bayston, R.

Abstract

All implants are rapidly coated by the host with glycoproteins forming a thin capsule, and this is a normal response. Where an inflammatory stimulus such as infection is present, the capsule can thicken and become microvascularised and sometimes calcified. This inflammatory stimulus can take the form of leachable chemicals from the implant, or bacteria live or dead. The presence of live bacteria can lead to biofilm development which is part of the chronic infective, inflammatory process. Staphylococcus epidermidis and Cutibacterium acnes have been implicated in chronic infection around breast implants, and some animal models suggest their involvement in capsule contracture. Molecular methods have revealed an array of microorganisms from samples of removed capsular material, but they are extremely sensitive to contamination and the relevance of the results to capsular contracture is in doubt. There is evidence that bacteria of low virulence are associated with capsular contracture and calcification, and measures beyond those conventionally applied need to be investigated to limit perioperative contamination.

Citation

Bayston, R. (2022). Capsule formation around breast implants. Journal of Plastic, Reconstructive and Aesthetic Surgery, 31, 123-128. https://doi.org/10.1016/j.jpra.2021.11.004

• Journal Article Type: Article
• Acceptance Date: Nov 18, 2021
• Online Publication Date: Dec 1, 2021
• Publication Date: 2022-03
• Deposit Date: Dec 2, 2021
• Publicly Available Date: Dec 2, 2022
• Journal: Journal of Plastic, Reconstructive and Aesthetic Surgery
• Print ISSN: 1748-6815
• Electronic ISSN: 2352-5878
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 31
• Pages: 123-128
• DOI: https://doi.org/10.1016/j.jpra.2021.11.004
• Keywords: Breast implant; capsular contracture; calcification; low-grade infection
• Public URL: https://nottingham-repository.worktribe.com/output/6846125
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S2352587821000991