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The double capsules in macro-textured breast implants
Jean-Philippe Giot1, Laurence S Paek1, Nathanael Nizard1
1Division of Plastic Surgery, Department of Surgery, CHUM Montreal University Health Center, 1650 Sherbrooke East, Montréal, Québec H2L 4M1, Canada.
Biomaterials
|July 27, 2015
Summary
The double capsule complication in breast implants, causing displacement, is linked to mechanical factors. Bacterial presence and biofilm at the prosthesis interface suggest a role in this phenomenon.
Area of Science:
- Plastic Surgery
- Biomaterials Science
- Microbiology
Background:
- Breast implants are common for aesthetic and reconstructive surgery.
- Textured prostheses can develop a double capsule, leading to displacement.
- The cause of the double capsule complication remains unclear.
Purpose of the Study:
- To investigate the etiology of the double capsule complication in breast expander implants.
- To analyze the histological and microbiological characteristics of double capsules.
Main Methods:
- Histological analysis of 10 double capsules from breast expander implants.
- Scanning electron microscopy (SEM) to examine the prosthesis interface (PI) and intercapsular space (ICS).
- Microbiological assessment of bacterial presence and biofilm.
Main Results:
- Histology showed organized collagen sheets with fiber delamination in the inner capsule.
- SEM revealed a textured layer at the PI mirroring implant texture, and a flat surface at the ICS.
- Significant bacterial presence and biofilm were found at the PI, with less at the ICS.
Conclusions:
- The double capsule phenomenon likely originates from mechanical factors.
- Capsular delamination creates the intercapsular space, altering implant biostability.
- Bacterial presence at the prosthesis interface may contribute to the complication.
