Subclinical infection of the silicone breast implant surface as a possible cause of capsular contracture

• Published in: Aesthetic plastic surgery 1992, Vol.16 (2), p.173-179
• Main Authors: VIRDEN, C. P, DOBKE, M. K, STEIN, P, LOWELL PARSONS, C, FRANK, D. H
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Contracture - microbiology; Female; Humans; Mammaplasty - adverse effects; Medical sciences; Middle Aged; Prostheses and Implants - adverse effects; Prosthesis-Related Infections - complications; Silicones; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Tissue Expansion Devices
• ISSN: 0364-216X; 1432-5241
• DOI: 10.1007/bf00450610

In order to reexamine the possible association between bacterial presence and capsular contracture, 55 silicone devices (mammary implants or tissue expanders) were cultured at the time of their removal from 40 patients. Special culture techniques were used in an attempt to recover bacteria adhering to the smooth-surfaced implant and encased in glycocalyx biofilm. Bacteria were detected on 56% (15 of 27) of implants surrounded by contracted capsules and on 18% (5 of 28) of those without capsular contracture (p less than 0.05). Only three implants tested positive using routine plating techniques. The predominant isolate was Staphylococcus epidermidis. The concept that capsular contracture is associated with subclinical infection of silicone implants is supported by this study. With changes in the microbiological technique, bacterial recovery and growth occurs at a frequency greater than previously thought.