Inflammatory response to various implant surfaces in murine models: A systematic analysis

Area of Science:

• Biomaterials Science
• Immunology
• Surgical Innovation

Background:

• Breast implants (BIs) are widely used but associated with complications like capsular contracture.
• Understanding host-implant interactions, particularly surface texture effects, is crucial for mitigating BI risks.
• ISO 14607:2018 standardizes BI surface classifications, guiding research into their biological impact.

Purpose of the Study:

• To systematically review murine model studies on the effects of different breast implant surface textures on inflammatory response and capsule formation.
• To correlate BI surface characteristics (smooth, microtextured, macrotextured, polyurethane foam-coated) with biological outcomes.
• To inform improved breast implant design for better clinical results.

Main Methods:

• A PRISMA-guided systematic review of 4 databases was performed.
• Included studies utilized murine models investigating breast implant surface variations.
• Excluded studies involved non-murine models, human subjects, or external interventions.

Main Results:

• Smooth implants correlated with thinner, organized capsules and minimal inflammation.
• Microtextured implants showed moderate tissue integration and variable inflammatory responses.
• Macrotextured and polyurethane foam-coated (PU) implants induced significant tissue reactions, including increased neoangiogenesis and thicker, more cellular capsules.

Conclusions:

• Breast implant surface texture is a critical determinant of host response.
• Increasing surface texture correlates with denser capsule formation and heightened inflammatory patterns.
• Findings emphasize the need to consider surface topography in breast implant design to minimize adverse outcomes.