Although outstanding technological advances in cosmetic surgery are a regular occurrence, there has been little development over the years in breast augmentation, one of the most popular cosmetic surgeries. It is surprising that the surfaces of breast implants used today were originally designed in the 1960s and 1970s when the developers thought that ’bumps’ on the implant surfaces had an adverse effect on recovery. It has since been shown that rougher or textured surfaces actually reduce the amount of scar tissue formed around breast implants and therefore a new surface design could help to prevent complications such as capsular contracture.
Around one in five people with breast implants suffer from capsular contracture. This is a very painful condition where scar tissue forms and then shrinks after surgery causing deformity, leakage from the implants and the need for further surgery. Capsular contracture occurs because the implant is a foreign object which the body resists.
Scientists at the University of Manchester have recognised the need for modernisation of implants and have created an enhanced surface for silicone breast implants which could reduce complications and make the implants less likely to be rejected by the body. They have developed a new surface for implants by creating a pattern which mimics the body’s own surface, such as the basal layer of the skin, to provide a better environment for the cells to grow in.
Dr Ardeshir Bayat from the University’s Institute of Inflammation and Repair, who led the study, said: “The surfaces of breast implants in use today have relatively large features on their surface, which have no discernible correlation with biological features required for cells to interact with. Importantly, the micro environment created by the features of a breast implant is critical for breast tissue cells to adhere to that surface and grow on. Compared to the size of the cells, these bumps on existing implants are so large that they’re effectively a smooth cliff face compared to the dimensions required for the cell to interact with.
“What we did was to reduce the size, dimension and appearance of these bumps down from the size of say, a hill, to that of a pebble. This makes interaction at the cellular level much better. Our approach was to create a novel surface which mimics the basal layer of the skin, which the body’s cells are more likely to recognise and interact with favourably.”
The scientists carried out tests in the lab over a period of one week - the critical period for recovery from surgery. The results show that the new surface reduced the foreign body reaction when compared to the smooth and larger textured surfaces currently available on the market.
The researchers appreciate that much more work needs to be done before these implants could be made available on the open market but the outcome from these tests is positive and Dr Bayat hopes this is a step towards “delivering the next generation of biomimetic breast implant surfaces.”
The study was published in the journal Biomaterials: ‘Development and functional evaluation of biomimetic silicone surfaces with hierarchical micro/nano-topographical features demonstrates favourable in vitro foreign body response of breast-derived fibroblasts’ (see here).
Sarah Gubbins, an associate solicitor in the cosmetic surgery team at Penningtons Manches, said: “Unfortunately, capsular contracture is an unpleasant complication of breast augmentation surgery when scar tissue develops. This is a very interesting study and we are excited to hear about further development of the technology. With breast augmentation being such a popular procedure, we are hopeful that, if the new implant surface becomes available on the open market, it may help to minimise the risk of complications for future patients.”