Munhoz Alexandre Mendonça, Clemens Mark W, Nahabedian Maurice Y
Plastic Surgery Division, Hospital Sírio-Libanês, São Paulo, Brazil.
Breast Surgery Group, Plastic Surgery Division, University of São Paulo School of Medicine, São Paulo, Brazil.
Plast Reconstr Surg Glob Open. 2019 Oct 15;7(10):e2466. doi: 10.1097/GOX.0000000000002466. eCollection 2019 Oct.
Most commercially available breast implants feature some degree of elastomer surface modifications to increase surface roughness, in part because several clinical series have demonstrated positive outcomes from texturizing. However, the literature shows that textured implants support higher rates of bacterial growth, and there is a clear association between increased bacterial contamination and host response in vivo, such as capsular contracture. Furthermore, the infectious theory related to bacterial contamination has recently been described as a potential cause in the etiology of anaplastic large-cell lymphoma. Recent research has focused on the physiology of breast implant surfaces advances and how they interact with the body, creating new surface technologies which have the potential to affect all aspects of breast surgery. Understanding how surface properties affect inflammatory cell response will be essential in designing implants that can provide an esthetic solution while also minimizing long-term clinical complications. This special topic highlights the current knowledge on silicone implant surfaces, as well as innovations that have shaped and will continue to change the silicone breast implant industry in the future. It also provides an overview of the principal surfaces that exist and may find clinical applications in esthetic and reconstructive breast surgery. As additional advances emerge, objective tools will be required to evaluate the different surfaces available on the market, along with the long-term efficacy of new technologies.
大多数市售的乳房植入物都有一定程度的弹性体表面改性，以增加表面粗糙度，部分原因是几个临床系列研究表明纹理化能带来积极效果。然而，文献显示纹理化植入物支持更高的细菌生长率，并且在体内细菌污染增加与宿主反应（如包膜挛缩）之间存在明显关联。此外，与细菌污染相关的感染理论最近被描述为间变性大细胞淋巴瘤病因中的一个潜在原因。最近的研究集中在乳房植入物表面生理学的进展以及它们如何与身体相互作用，创造出有可能影响乳房手术各个方面的新表面技术。了解表面特性如何影响炎症细胞反应对于设计既能提供美学解决方案又能将长期临床并发症降至最低的植入物至关重要。本专题重点介绍了关于硅胶植入物表面的当前知识，以及已经塑造并将在未来继续改变硅胶乳房植入物行业的创新。它还概述了现有的主要表面，这些表面可能在美学和重建性乳房手术中找到临床应用。随着更多进展的出现，将需要客观工具来评估市场上可用的不同表面以及新技术的长期疗效。
