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Cheng M, Janzekovic J, Finze R, Mohseni M, Saifzadeh S, Savi FM, Ung O, Wagels M, Hutmacher DW. Conceptualizing Scaffold Guided Breast Tissue Regeneration in a Preclinical Large Animal Model. Bioengineering (Basel) 2024; 11:593. [PMID: 38927829 PMCID: PMC11200919 DOI: 10.3390/bioengineering11060593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/20/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
Scaffold-guided breast tissue regeneration (SGBTR) can transform both reconstructive and cosmetic breast surgery. Implant-based surgery is the most common method. However, there are inherent limitations, as it involves replacement of tissue rather than regeneration. Regenerating autologous soft tissue has the potential to provide a more like-for-like reconstruction with minimal morbidity. Our SGBTR approach regenerates soft tissue by implanting additively manufactured bioresorbable scaffolds filled with autologous fat graft. A pre-clinical large animal study was conducted by implanting 100 mL breast scaffolds (n = 55) made from medical-grade polycaprolactone into 11 minipigs for 12 months. Various treatment groups were investigated where immediate or delayed autologous fat graft, as well as platelet rich plasma, were added to the scaffolds. Computed tomography and magnetic resonance imaging were performed on explanted scaffolds to determine the volume and distribution of the regenerated tissue. Histological analysis was performed to confirm the tissue type. At 12 months, we were able to regenerate and sustain a mean soft tissue volume of 60.9 ± 4.5 mL (95% CI) across all treatment groups. There was no evidence of capsule formation. There were no immediate or long-term post-operative complications. In conclusion, we were able to regenerate clinically relevant soft tissue volumes utilizing SGBTR in a pre-clinical large animal model.
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Affiliation(s)
- Matthew Cheng
- Centre for Regenerative Medicine, Q Block—Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; (M.C.); (J.J.); (R.F.); (M.M.); (S.S.); (F.M.S.); (M.W.)
- Plastic and Reconstructive Surgery, Princess Alexandra Hospital, 199 Ipswich Road, Woollongabba, Brisbane, QLD 4102, Australia
| | - Jan Janzekovic
- Centre for Regenerative Medicine, Q Block—Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; (M.C.); (J.J.); (R.F.); (M.M.); (S.S.); (F.M.S.); (M.W.)
| | - Ronja Finze
- Centre for Regenerative Medicine, Q Block—Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; (M.C.); (J.J.); (R.F.); (M.M.); (S.S.); (F.M.S.); (M.W.)
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Mina Mohseni
- Centre for Regenerative Medicine, Q Block—Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; (M.C.); (J.J.); (R.F.); (M.M.); (S.S.); (F.M.S.); (M.W.)
| | - Siamak Saifzadeh
- Centre for Regenerative Medicine, Q Block—Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; (M.C.); (J.J.); (R.F.); (M.M.); (S.S.); (F.M.S.); (M.W.)
- Medical Engineering Research Facility, Queensland University of Technology, Staib Road, Chermside, Brisbane, QLD 4032, Australia
| | - Flavia M. Savi
- Centre for Regenerative Medicine, Q Block—Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; (M.C.); (J.J.); (R.F.); (M.M.); (S.S.); (F.M.S.); (M.W.)
| | - Owen Ung
- Breast and Endocrine Surgery, Royal Brisbane and Women’s Hospital, Butterfield St, Herston, Brisbane, QLD 4029, Australia;
| | - Michael Wagels
- Centre for Regenerative Medicine, Q Block—Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; (M.C.); (J.J.); (R.F.); (M.M.); (S.S.); (F.M.S.); (M.W.)
- Plastic and Reconstructive Surgery, Princess Alexandra Hospital, 199 Ipswich Road, Woollongabba, Brisbane, QLD 4102, Australia
- Herston Biofabrication Institute, Royal Brisbane and Women’s Hospital, Level 12 Block 7, Cnr Butterfield St & Bowen Bridge Rd, Herston, Brisbane, QLD 4029, Australia
| | - Dietmar W. Hutmacher
- Centre for Regenerative Medicine, Q Block—Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia; (M.C.); (J.J.); (R.F.); (M.M.); (S.S.); (F.M.S.); (M.W.)
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Szychta P. Advancements in Aesthetic Breast Augmentation: Evaluating the Safety, Efficacy, and Naturalistic Outcomes of Ergonomix2 Implants. Aesthetic Plast Surg 2024:10.1007/s00266-024-03994-3. [PMID: 38580867 DOI: 10.1007/s00266-024-03994-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/04/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND This pioneering study evaluates the safety, efficacy, and Aesthetic outcomes of Ergonomix2 Motiva Ergonomic Implants in breast augmentation. It aims to assess their capability to offer more natural touch and dynamics, delineate the learning curve for surgical techniques, and examine their safety profile compared to Ergonomix1 implants. MATERIALS AND METHODS A prospective cohort study was conducted, comparing 31 patients who received Ergonomix2 implants with a control group of 51 patients with Ergonomix1 implants. Eligible patients were those seeking Aesthetic breast augmentation without prior surgeries or chronic illnesses. Detailed documentation of surgical techniques, implant characteristics, and patient demographics was performed. The study assessed surgical learning curve, implant positioning accuracy, and short-term and early complications. Aesthetic outcomes were evaluated using the BreastQ questionnaire and quantitative elastography. RESULTS Patients with Ergonomix2 implants showed significant improvements in Aesthetic outcomes, including breast contour symmetry and natural feel. The learning curve demonstrated a decrease in surgical time and higher implant positioning accuracy. The safety profile was favorable, with a low complication rate and high patient satisfaction levels. Ergonomix2 implants exhibited enhanced softness and pliability, closely mimicking natural breast tissue, as confirmed by elastographic analyzes. CONCLUSIONS Ergonomix2 implants represent a significant advancement in Aesthetic breast surgery, offering natural-feeling and dynamically adaptable outcomes. Despite the promising results, the need for specialized surgical techniques and further research on long-term safety and efficacy is emphasized. This study contributes foundational knowledge to the field of ergonomic breast implants and their application in modern plastic surgery. LEVEL OF EVIDENCE II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Pawel Szychta
- Dr Szychta Clinic chirurgiaplastyczna.pl, Zabi Kruk 10, 80-822, Gdansk, Poland.
- Mother's Poland Memorial Hospital - Research Institute, Lodz, Poland.
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Brown T, Harvie F, Kluess D. Testing Mechanical Properties of Silicone Gel-Filled Breast Implants and Their Degradation. Aesthetic Plast Surg 2024:10.1007/s00266-024-03886-6. [PMID: 38438757 DOI: 10.1007/s00266-024-03886-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/30/2024] [Indexed: 03/06/2024]
Abstract
Breast augmentation procedures using silicone implants have become increasingly popular over the past six decades. This article addresses the concerns of patients regarding implant strength by providing clinicians with valuable information in addition to video and pictorial evidence to share, fostering reassurance. The article focuses on the structural integrity and stability of breast implants, which play a critical role in their long-term performance and patient satisfaction. Specifically, it examines the industry standards outlined by the International Organization for Standardization (ISO), with a particular emphasis on ISO14607-2018, which encompasses a range of mechanical and physio-mechanical tests, including the assessment of silicone gel-fill firmness, evaluation of shell integrity, and examination of the impact of environmental conditions on implant performance. Breast implants are not static devices and are subject to aging and fatigue-based degradation. This emphasizes the need for ongoing monitoring and evaluation to ensure the long-term safety and satisfaction of patients. By providing a comprehensive examination of breast implant structure and industry standards, this article equips clinicians with the necessary knowledge to address patient concerns and foster confidence in the safety and longevity of breast augmentation procedures using silicone implants.Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
| | - Fraser Harvie
- NEX2GEN, Bayhead, Isle of North Uist, Scotland, HS6 5DS, UK
| | - Daniel Kluess
- INNOPROOF GmbH, Joachim-Jungius-Straße 9, 18059, D-Rostock, Germany
- Department of Orthopaedics, Rostock University Medical Center, Doberaner Strasse 142, 18057, Rostock, Germany
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Awaida CJ, Paek L, Danino MA. A New Technique for Breast Pocket Adjustment: Argon Beam Thermal Capsulorrhaphy. Plast Reconstr Surg Glob Open 2022; 10:e4437. [PMID: 35923993 PMCID: PMC9325331 DOI: 10.1097/gox.0000000000004437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 05/24/2022] [Indexed: 11/25/2022]
Abstract
Implant malposition remains one of the main complications of aesthetic breast augmentation and alloplastic breast reconstruction with expanders and implants. Many capsulorrhaphy techniques have been described to adjust the breast pocket and correct the malposition. In this study, we tested the efficacy of the argon beam coagulator (ABC) for lateral capsulorrhaphy on breast reconstruction patients at the time of expander replacement with a permanent implant. We also experimentally compared the effects of the ABC and the standard electrocautery on fragments of healthy breast capsule. We noted a 69.5% capsule shrinkage with the ABC versus 46.8% with the standard electrocautery. We concluded that breast capsulorrhaphy using the ABC is a safe and efficient technique for the correction of breast implant malposition in both reconstructive and aesthetic breast surgery.
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Yi Z, Zeng J, Chen Z, Chen L, Lu HB, Zhang Q, Yang X, Qi Z. The Role of Verteporfin in Prevention of Periprosthetic Capsular Fibrosis: An Experimental Study. Aesthet Surg J 2022; 42:820-829. [PMID: 35420670 DOI: 10.1093/asj/sjac083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Capsular contracture (CC) characterized by excessive fibrosis is one of the most common complications after silicone implant surgery. Verteporfin (VP), an inhibitor of Yes-associated protein 1 (YAP1), has recently been found to reduce the fibrotic process. OBJECTIVES The aim of this study was to use an in vivo rabbit model to evaluate the efficacy of VP for the prevention of CC. METHODS Twenty-four New Zealand rabbits received 10-cc smooth saline silicone implants inserted in the dorsal skin and were randomly divided into 2 groups to receive 2 mL VP (1.5 mg/mL) or 2 mL phosphate-buffered saline solution instillation in the implant pocket. When the animals were killed on Day 60, capsule formation was observed both macroscopically and microscopically. Histologic evaluation included capsule thickness, fibrosis degree, and myofibroblast (α smooth muscle actin positive) content. In addition, the YAP1 expression level was examined by immunofluorescence staining. Transforming growth factor β1, collagen I, and connective tissue growth factor expression were measured by real-time quantitative polymerase chain reaction. RESULTS The VP-treated group exhibited thinner, more transparent capsules and less fibrosis than the control group at 60 days postsurgery (P < 0.05). Moreover, the VP treatment significantly reduced α smooth muscle actin, YAP1, transforming growth factor β1, collagen I, and connective tissue growth factor expression levels in the capsular tissues (P < 0.05). CONCLUSIONS VP reduced capsule formation after silicone implantation by inhibiting YAP1-mediated mechanical signaling, thereby attenuating excessive collagen deposition in the rabbit model. This preclinical study may provide a feasible strategy to prevent periprosthetic capsular fibrosis in clinical application.
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Affiliation(s)
- Zhen Yi
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Jinshi Zeng
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Zixiang Chen
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Lulu Chen
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Hai-bin Lu
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Qi Zhang
- Department of Plastic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Xiaonan Yang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Zuoliang Qi
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
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