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Positionally Stable Smooth Implants: An In Vivo Submuscular Model
Sophia Salingaros1, Matthew W Liao1, Tim Y Li1
1. Laboratory of Bioregenerative Medicine and Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY.
Plastic and Reconstructive Surgery
|January 21, 2026
Summary
New Positionally Stable Smooth Implants (PSSI) offer improved rotational stability in submuscular models. These novel implants may provide a safer alternative to textured devices, reducing inflammation and myofibroblast presence.
Area of Science:
- Biomaterials Science
- Plastic Surgery
- Regenerative Medicine
Background:
- Textured breast implants, previously favored for stability, were recalled due to BIA-ALCL risk.
- This led to a need for stable yet safe implant alternatives.
- Novel Positionally Stable Smooth Implants (PSSI) with surface wells were developed to promote tissue ingrowth and stability.
Purpose of the Study:
- To evaluate the positional stability and tissue response of PSSI in a submuscular placement model.
- To compare PSSI performance against traditional smooth and textured implants.
Main Methods:
- Miniature PSSI, smooth, and textured implants were fabricated from polydimethylsiloxane.
- Implants were surgically placed under the latissimus dorsi muscle in rats.
- Implant position, capsule collagen density, and macrophage expression were analyzed over 12 weeks.
Main Results:
- PSSI demonstrated significantly reduced rotation compared to smooth implants and comparable stability to textured implants.
- PSSI and textured implants showed lower collagen density and myofibroblast presence than smooth implants.
- PSSI exhibited reduced pro-inflammatory M1 macrophage expression compared to textured implants.
Conclusions:
- PSSI provide superior rotational stability in the submuscular plane compared to smooth implants.
- PSSI elicit a less inflammatory response and reduced fibrotic capsule formation than traditional textured implants.
- PSSI represent a promising alternative to textured implants for enhanced safety and stability.
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