Better Living Through Chemistry: A Novel Breast Implant Surface Coating Significantly Reduces Peri-Prosthetic Capsule Formation
Sarah J. Karinja, BA1, Omid Veiseh, Ph.D.2, Jaime Bernstein, BS1, Rachel Akintayo, BA1, Julia Jin, BS1, Xue Dong, BA1, Andrew Abadeer, MEng1, Omer Kaymakcalan, BA1, Kerry A. Morrison, BA1, Robert S. Langer, Sc.D.2, Daniel G. Anderson, Ph.D.2, Jason A. Spector, MD1.
1Weill Cornell Medical College, New York, NY, USA, 2Massachusetts Institute of Technology, Cambridge, MA, USA.
PURPOSE: The body responds to prosthetic devices with an inflammatory foreign body response and deposition of a fibrous capsule. Capsular contracture (CC) is the most common complication of aesthetic and reconstructive breast surgery. CC is the source of significant patient morbidity and can result in pain, suboptimal aesthetic outcomes, implant failure and increased costs. The underlying mechanism remains unknown. Treatment is limited to re-operation and capsule excision, however recurrence rates remain high. Herein we altered the surface chemistry of silicone implants with a proprietary anti-inflammatory coating to reduce capsule formation.
METHODS: Silicone implants were created from polydimethylsiloxane and coated with RZA15 or E9, two novel, biocompatible, anti-inflammatory, proprietary molecules. Uncoated, RZA15- and E9-coated implants were implanted in twenty C57BL/6 mice. After four weeks, peri-prosthetic tissue was removed for histologic analysis of capsule thickness.
RESULTS: After 31 days, there was a statistically significant reduction in capsule thickness of RZA15- (71.12 microns; p=0.0194) and E9-coated implants (76.84 microns; p=0.0463) compared to uncoated (103.8 microns).
CONCLUSION: Coating the surface of silicone implants with RZA15 and E9 significantly reduced capsule thickness in a mouse model for implant-based breast surgery. These results are promising as there are no known measures for preventing this highly morbid complication. Furthermore, as peri-prosthetic capsule formation is a complication without anatomical boundaries, this novel chemistry may have additional applications, including coating of any implanted device.
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