Biocompatibility of polyurethane-coated breast implants: A histological comparison of implant capsules
Issue title: Selected articles from the 3rd Joint Meeting of The European Society for Clinical Hemorheology and Microcirculation (ESCHM) , The International Society for Clinical Hemorheology (ISCH) and The International Society of Biorheology (ISB), Regensburg, Germany, 28 – 30 September 2023
Guest editors: L. Prantl, A. Krueger-Genge and F. Jung
Affiliations: [a] Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| [b] Faculty of Medicine, Medical University of Vienna, Vienna, Austria
| [c] Institute for Pathology, University Hospital Regensburg, Regensburg, Germany
| [d] Faculty of Medicine, University of Regensburg, Regensburg, Germany
Correspondence:
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Correspondence author: Dr. V. Tessmann, Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany. E-mail: dr.vanessa.tessmann@gmail.com.
Abstract: BACKGROUND:Biocompatibility describes the influence of materials on their biological environment. Implant material in the human body can cause a foreign body reaction and the formation of a capsule around the foreign material. Since capsular formation is the most frequent issue after breast-implant insertion, knowledge and awareness of biocompatibility is crucial, especially since worldwide, breast augmentation continues to be the most popular plastic surgery, with over 1.6 million procedures performed in 2020, according to surveys by the International Society of Aesthetic Plastic Surgery (ISAPS). MATERIAL AND METHODS:This study includes 80 capsular samples of female patients who underwent revision surgery after breast-implant insertion at the University Hospital Regensburg. Capsules of breast implants with different surface structures (smooth, textured and polyurethane-coated) and shapes (round-shaped, anatomically-shaped) were analyzed histologically after hematoxylin-eosin-staining in respect to capsular thickness and layer formation. RESULTS:Capsular thickness and layering showed a statistically significant difference between polyurethane-coated and smooth as well as polyurethane-coated and textured implants. Capsules around polyurethane-coated implants presented greater thickness. However, the difference between smooth and textured implants was not statistically significant. Furthermore, the shape of the implants also indicated a statistically significant difference in capsular thickness. Implants of anatomical shape resulted in a thinner capsule than round-shaped breast-implants. CONCLUSION:In conclusion, this study demonstrated a thicker capsule around polyurethane-coated breast implants and no difference in capsular thickness between smooth and textured breast implants. Anatomically shaped breast-implants presented a thinner capsule than round shaped breast-implants.
Keywords: Breast implants, capsular fibrosis, histological examinations, polyurethane
