Phosphorylcholine-coated silicone implants: effect on inflammatory response and fibrous capsule formation

INTRODUCTION: The formation of capsular fibrosis around silicone breast implants is a common complication in reconstructive and plastic surgery. Foreign body reaction-induced infections are quite common because of the hydrophobic surface properties of silicone and are, in addition, considered to be a causative factor of capsular fibrosis.

METHODS: In this experimental pilot study, 2 groups of 7 Sprague-Dawley rats were established to evaluate the periprosthetic collagen synthesis after implantation of coated silicone implants. In the first group, the textured minisilicone implants were implanted submuscularly. The second group received the biotechnologically, surface-modified phosphorylcholine (PC)-coated implants. After a 3-month period, all the rats were killed, and the capsules were examined in a histologic (hematoxylin-eosin and Masson-trichrom) and immunohistologic way (CD4, CD8, CD68, TGF-beta, fibroblasts, collagen type I, and collagen type III).

RESULTS: Significant differences were found to occur between the PC-coated and standard, textured implants with respect to the inflammatory reaction and collagen synthesis.

CONCLUSIONS: The production of hydrophilic surfaces in silicone implants by way of PC-coating causes a decrease in the inflammatory reaction, and thus, a reduction of periprosthetic fibrosis. This could form the basis of a cost-effective, preventive, and therapeutic strategy with respect to the decrease in capsular fibrosis occurrence.