Various Approaches Including Novel Nano/Microtechniques to Reduce Silicone Implant-Induced Contracture with Adverse Immune Responses

To date, a wide variety of studies has investigated the reduction of capsular contracture caused by silicone implants. However, complications caused by silicone implants remain unresolved. Researchers are attempting to reduce these complications. Studies focusing on developing implant surfaces similar to human tissues are of particular importance. A physiological ECM-like surface reduces inflammatory foreign body reactions and modulates the immune response. The plastic and reconstructive surgery fields have significantly benefited from nano/microtechnology in cosmetic dermatological applications, wound healing, implant and prosthesis development, tissue engineering and regenerative medicine, and drug delivery materials. In particular, the development of materials has evolved due to nano/microtechnology that enables the analysis of material surface topography. Recently, a novel implant technology utilizing various nano-/micro-engineering techniques has emerged. Development of implants using these new technologies would allow increasingly natural interactions between the implants and surrounding tissues, which would reduce the peri-implant inflammatory response in the clinic and the induction of chronic inflammation in cells and tissues. Although no clinical long-term follow-up results on these implants have been reported, novel implant surfaces with improved interactions with surrounding tissues may reduce the risk of capsular contracture and should improve the results in anaplastic large cell lymphoma. In the field of plastic and reconstructive surgery, the nano/microtechnology that develops more advanced biocompatible implant will continue to grow and expand, and continued research is needed on new biomaterials that mimic human tissues. 

The present article provides an overview of the currently available techniques, including systemic drugs, topical application, autologous tissue, acellular dermal matrix, surface type and novel nano/microtechniques, to reduce silicone implant-induced contracture and associated foreign body responses.  

The novel approaches of nano/microtechnology being applied in breast implant develpoment such as nano/microtopographies induce favorable biointegration and enhance biocompatibility. Surface modification with nano/microtopographies integrated controlled-release antimicrobial or anti-inflammatory agents potentially could reduce capsular contracture. Nanoscale architecture could alter the body’s immune response to the breast implant or minimize biofilm formation and affect the subsequent degree of capsular contracture. This can lead to the development of permanently implantable materials with immunologically inactive nano-engineered surface. Furthermore, in the near future, nano/microelectromechanical devices and breast cancer cell specific proteins integrated with novel implants could be used to detect cancer cells, cancer recurrence and treat pathologic cells.