Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Is it all about Surface Topography? An Intraindividual Clinical Outcome Analysis of Two Different Implant Surfaces in Breast Reconstruction

Ines Schoberleitner
ORCID logo ,
Angela Augustin
ORCID logo ,
Daniel Egle
,
Christine Brunner
,
Birgit Amort
,
Bettina Zelger
,
Andrea Brunner
,
Dolores Wolfram
* ORCID logo
Version 1 : Received: 30 November 2022 / Approved: 2 December 2022 / Online: 2 December 2022 (07:40:06 CET)

A peer-reviewed article of this Preprint also exists.

Schoberleitner, I.; Augustin, A.; Egle, D.; Brunner, C.; Amort, B.; Zelger, B.; Brunner, A.; Wolfram, D. Is It All about Surface Topography? An Intra-individual Clinical Outcome Analysis of Two Different Implant Surfaces in Breast Reconstruction. J. Clin. Med. 2023, 12, 1315. Schoberleitner, I.; Augustin, A.; Egle, D.; Brunner, C.; Amort, B.; Zelger, B.; Brunner, A.; Wolfram, D. Is It All about Surface Topography? An Intra-individual Clinical Outcome Analysis of Two Different Implant Surfaces in Breast Reconstruction. J. Clin. Med. 2023, 12, 1315.

Abstract

The most common long-term complication of silicone breast implants (SMI) remains capsular fibrosis. The etiology of this exaggerated implant encapsulation is multifactorial but primarily induced by the host response towards the foreign material silicone. Identified risk factors included specific implant topographies. Of note, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), has only been observed in response to textured surface implants. We hypothesize that reduction of SMI surface roughness causes less host response hence better cosmetic outcome with fewer complications for the patient. A total of 7 patients received the routinely used CPX®4 breast expander (~60 µM Ra) and the novel SmoothSilk® (~ 4 µM Ra), fixed prepectoral with a titanised mesh pocket and randomized to the left or right breast after bilateral prophylactic NSME (nipple-sparing mastectomy). We aimed to compare the postoperative outcome regarding capsule thickness, seroma formation, rippling, implant dislocation as well as comfortability and practicability. Our analysis shows that surface roughness is an influential parameter in controlling fibrotic implant encapsulation. First time intra-individually compared in patients, our data confirm an improved biocompatibility with minor capsule formation around SmoothSilk® implants with an average shell roughness of 4 µM and in addition an amplification of host response by titanised implant pockets.

Keywords

nipple-sparing mastectomy; prophylactic implant-based breast reconstruction; SMI (silicone mammary implants); SMI surface topography; surface roughness; fibrosis; capsular contracture; aesthetic outcome; intra-individual comparison; titanised mesh implant pocket

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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