Association Between Breast Microbiota and Capsular Contracture: A Systematic Review.

Area of Science:

• Plastic Surgery
• Microbiology
• Biomaterials Science

Background:

• Capsular contracture (CC) is a frequent complication following breast implant surgery.
• The exact cause of CC remains unclear, though subclinical infection is suspected.
• Specific bacterial involvement, particularly from the breast microbiota, requires further investigation.

Purpose of the Study:

• To systematically review the association between breast microbiota, bacterial biofilms, and capsular contracture in patients with breast implants.
• To evaluate the role of frequently identified microorganisms in the development of CC.

Main Methods:

• Systematic review of English-language articles identified via Medline and Embase.
• Inclusion criteria focused on patient, surgical, and implant factors related to CC.
• Microbiota assessment primarily used cell culture or pathology; one study utilized PCR.

Main Results:

• The review analyzed data from 428 women (453 breast implants).
• Frequently isolated bacteria included Staphylococcus epidermidis, Propionibacterium acnes, and Streptococcus spp.
• Bacterial biofilms, especially involving S. epidermidis, were consistently found in contracted capsules.

Conclusions:

• A strong association exists between specific breast microbiota, particularly S. epidermidis biofilms, and capsular contracture.
• Further molecular studies are needed to definitively establish the causal link between breast microbiota and CC.