Clinical significance of intracapsular fluid in patients' breast implants

Clinical reports on the incidence and clinical significance of intracapsular fluid are lacking in the literature. It remains unknown whether the presence of intracapsular fluid has any relation to implant infection or colonization. The purpose of this study was to determine the frequency and type of intracapsular fluid, specifically, whether intracapsular fluid causes implant infection, implant rupture, or bacterial colonization. A total of 139 implants from 72 symptomatic patients were entered into the prospective clinical study. Our study demonstrated the presence of intracapsular fluid in 21 of 139 (15%) implants. Positive microbial cultures were identified in 39% of the implants in the positive intracapsular fluid group, compared to 43% in the negative fluid group. There was no statistically significant difference between these groups. Also, no adverse clinical relationship was demonstrated between local symptoms and presence of intracapsular fluid. There was, however, a positive trend toward the presence of fluid when implant shell types were nonsmooth (polyurethane and textured silicone implants). Further studies are indicated to elucidate the fluid production mechanism and possible secretory activity of prosthetic capsules interfacing the textured breast implant surface.