Mechanical and surface chemical analysis of retrieved breast implants from a single centre

Louise J Magill; Aleksandra Tanska; Mohammed Keshtgar; Ashfin Mosahebi; Gavin Jell

doi:10.1016/j.jmbbm.2018.10.042

Mechanical and surface chemical analysis of retrieved breast implants from a single centre

J Mech Behav Biomed Mater. 2019 Mar:91:24-31. doi: 10.1016/j.jmbbm.2018.10.042. Epub 2018 Nov 2.

Authors

Louise J Magill¹, Aleksandra Tanska², Mohammed Keshtgar², Ashfin Mosahebi³, Gavin Jell²

Affiliations

¹ Division of Surgery and Interventional Science, Royal Free Campus, University College London, Pond Street, London NW3 2QG, United Kingdom. Electronic address: louise.magill.14@ucl.ac.uk.
² Division of Surgery and Interventional Science, Royal Free Campus, University College London, Pond Street, London NW3 2QG, United Kingdom.
³ Division of Surgery and Interventional Science, Royal Free Campus, University College London, Pond Street, London NW3 2QG, United Kingdom; Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, Pond Street, London NW3 2QG, United Kingdom.

PMID: 30529983
DOI: 10.1016/j.jmbbm.2018.10.042

Abstract

Introduction: Breast implants are associated with complications such as capsular contracture, implant rupture and leakage often necessitating further corrective surgery. Re-operation rates have been reported to occur in up to 15.4% of primary augmentation patients and up to 27% in primary reconstructions patients within the first three years (Cunningham, 2007). The aim of this study was to examine the mechanical and surface chemical properties as well as the fibroblast response of retrieved breast implants in our unit to determine the in vivo changes which occur over time.

Methods: Ethical approval was obtained. 47 implants were retrieved. Implantation time ranged from 1 month to 388 months (Mean 106.1 months). Tensile strength, elongation, Young's modulus and tear strength properties were measured using Instron 5565 tensiometer on anterior and posterior aspects of the implant. Attenuated total reflectance-fourier transform infra-red spectroscopy (ATR-FTIR), wettability and scanning electron microscopy (SEM) analysis was performed on the shell surfaces. Bicinchoninic acid assay was performed to determine shell protein content. The fibroblast response was determined by seeding HDFa cells on the retrieved implants and cell metabolism measured using Alamar Blue™ assay.

Results: Mechanical properties fall with increasing duration of implantation. There were no significant changes in ATR-FTIR spectra between ruptured and intact implants nor significant changes in wettability in implants grouped into 5 year categories. SEM imaging reveals surface degradation changes with increasing duration of implantation.

Conclusions: With increasing duration of implantation, mechanical properties of the breast implants fall. However this was not associated with surface chemical changes as determined by ATR-FTIR and wettability nor protein content of the shells. Thus the reduction in mechanical properties is associated with breast implant failure but further research is required to elucidate the mechanisms.

Keywords: Breast Implant; Breast Reconstruction; Failure; Silicone Implant.

MeSH terms

Breast Implants*
Humans
Materials Testing*
Mechanical Phenomena*
Middle Aged
Quinolines / analysis
Wettability

Substances

Quinolines
bicinchoninic acid