Breast Implants: Biomaterials, Surfaces, Biocompatibility-A Biomedical Engineering Perspective.

Area of Science:

• Biomaterials Science
• Plastic Surgery
• Immunology

Background:

• Breast implants are widely used medical devices in aesthetic and reconstructive surgery.
• They significantly impact psychosocial well-being, particularly in postmastectomy patients.
• Historical attempts at reconstruction faced severe complications, driving innovation.

Purpose of the Study:

• To provide a comprehensive review of breast implant development, biological interactions, and clinical outcomes.
• To discuss surgical considerations and their impact on outcomes and risks.
• To highlight the foreign body response and associated complications.

Main Methods:

• Literature review of historical development, material science, and clinical studies.
• Analysis of surgical techniques, implant classifications, and surface topography.
• Examination of biological interactions, including the foreign body response and inflammatory processes.

Main Results:

• Evolution from early materials to silicone gel and saline implants, including cohesive gels.
• Key surgical planes (subglandular, submuscular, dual-plane) influence outcomes and risks.
• Complications include capsular contracture, rupture, infection, and BIA-ALCL; surface characteristics affect host response.

Conclusions:

• Advances in biomaterials and surface engineering aim to improve biocompatibility and safety.
• Standardized testing protocols are crucial for evaluating implant performance.
• Understanding the implant-tissue interface and foreign body response is key to mitigating long-term complications.