Characterisation of breast implant surfaces and correlation with fibroblast adhesion.

Background: Capsular contracture formation is a common complication following breast augmentation surgery. Breast implant shells have either a smooth or a textured surface. Smooth surfaces demonstrate a higher incidence of contracture formation. The 3-dimensional surface of textured implants is thought to disrupt contractile forces and reduce capsular contracture rates.

Objective: To investigate the interaction of fibroblasts with silicone breast implant surfaces through characterization of their unique features.

Methods: Surfaces of smooth and textured breast implants were characterized using a confocal laser scanning microscope, a microtest 5 kN tensile testing device, and a contact angle goniometer. The kinetics of fibroblast interaction with these surfaces was further analysed.

Results: The textured surfaces were rough, and nodular containing high peaks and deep crevasses with roughness (Sa) values in the range 8.88-18.83 μm and contact angles between 130° and 142°. The smooth implant surfaces were less rough, more regular and repetitive with 0.06-0.07 μm surface roughness, and contact angles between 110.9° and 111.8°. The textured surfaces displayed higher bending stiffness than the smooth surfaces (0.19 and 0.26 N mm). Significant (p<0.05) numbers of fibroblasts were attached to the textured surfaces compared to the smooth surfaces which had higher levels of cell adhesion with surface roughness above 8 μm and contact angles above 130°.

Conclusions: In summary, surfaces with arithmetical mean deviation of greater roughness and reduced hydrophilicity with high water contact angles enhanced cell adhesion. These features aid design of improved surfaces, which may help, in prevention of breast capsular formation.