Mentor Corporation, the company that makes what we consider to be the best breast implants in the world, held a conference last week to update the local plastic surgery community on advances being made in the realm of bio film technology. This wasn’t about biological movies but rather how bacteria gain a foothold in the human body and survive despite our best efforts, both by drugs and by our own immune systems, to destroy them. This is important in understanding the causes of implant capsule formation and what we can do to prevent it. Implant capsules form in a small number of patients and can result in a firm breast.
Bio films are a layer of material that are formed by bacteria and act as a platform for the congregation and promotion of bacterial growth. They are a biological scaffolding that is hard to remove. When bacteria grow on these scaffolds they act as a community and actually communicate through chemical secretion. They can withstand the effects of high power antibiotics by allowing the upper layer of bacteria in the colony to be killed and not have the drugs penetrate to affect the lower layers. When the antibiotics are no longer present the under layers of bacteria are free to grow again. It is the presence of these bio films that stimulate scar production and thus capsule formation after breast augmentation.
The medical research community is now focusing on ways to dissolve bio films to eliminate their possible negative effects after implant placement.
Currently the best way to deal with bacterial growth and bio film is to not let it occur. We do this in our operations by using sterile technique, giving our patients antibiotics before we start surgery and being sure there is little to no bleeding in the pocket which could help the bacteria. The implants come sterile but we routinely wash them in a triple antibiotic solution that we also irrigate the pocket with before placing the implant. This makes it difficult for bacteria to grow and helps explain why we have such excellent results.
All the best,