How the surfaces of silicone breast implants affect the immune system

Implant surface topography can influence the development of scarring, inflammation, and other complications, researchers find.

Every year, about 400,000 people receive silicone breast implants in the United States. According to data from the U.S. Food and Drug Administration, a majority of those implants needs to be replaced within 10 years due to the buildup of scar tissue and other complications.

A team led by MIT researchers has now systematically analyzed how the varying surface architecture found in these implants influences the development of adverse effects, which in rare cases can include an unusual type of lymphoma.

“The surface topography of an implant can drastically affect how the immune response perceives it, and this has important ramifications for the [implants’] design,” says Omid Veiseh, a former MIT postdoc. “We hope this paper provides a foundation for plastic surgeons to evaluate and better understand how implant choice can affect the patient experience.”

The findings could also help scientists to design more biocompatible implants in the future, the researchers say.

“We are pleased that we were able to bring new materials science approaches to better understand issues of biocompatibility in the area of breast implants. We also hope the studies that we conducted will be broadly useful in understanding how to design safer and more effective implants of any type,” says Robert Langer, the David H. Koch Institute Professor at MIT and the senior author of the study.

Veiseh, who is now an assistant professor at Rice University, and Joshua Doloff, a former MIT postdoc who is now an assistant professor at Johns Hopkins University, are the lead authors of the paper, which appears today in Nature Biomedical Engineering. The research team also includes scientists from Rice University, Johns Hopkins, Establishment Labs, and MD Anderson Cancer Center, among other institutions.

Surface analysis

Silicone breast implants have been in use since the 1960s, and the earliest versions had smooth surfaces. However, with these implants, patients often experienced a complication called capsular contracture, in which scar tissue forms around the implant and squeezes it, creating pain or discomfort as well as visible deformation of the implant. These implants could also flip after implantation, requiring them to be surgically adjusted or removed.