Effect of Different Medications on Capsule Formation Around Miniaturized Breast Implants in Murine Models-a Systematic Review

BackgroundBreast implants (BIs) lead to the formation of a periprosthetic capsule, causing complications like capsular contracture. Gel bleeding, involving minor silicone gel leakage through the intact implant shell, significantly promotes capsular contracture. Various pharmacological and surface treatment strategies have been explored to mitigate these issues.ObjectivesThis review assesses the effectiveness of different pharmacological interventions and BIs surface coatings on periprosthetic capsule development in murine models.MethodsA systematic review adhering to the PRISMA protocol was conducted. Databases searched included PubMed, Google Scholar, Cochrane Library, and LILACS using keywords: (Murine) AND (Breast) AND/OR (Implant), covering studies from 1977 to 2022. Experimental studies on miniature breast implants in murine models involving medications, surface treatments, or post-surgical therapies were included. Exclusions were studies without pharmacological agents, those testing bacterial contamination, radiotherapy, or involving different animal models or humans.ResultsTwenty-nine articles were reviewed. Significant reductions in capsule thickness and inflammation were noted with certain pharmacological treatments. Corticosteroids and immunosuppressants were effective but raised concerns about wound healing and tumor recurrence. Leukotriene receptor antagonists (LTRA) showed promise in reducing capsule formation, especially in textured implants. Acellular dermal matrices (ADMs) enhanced tissue integration and reduced complications regardless of texture.ConclusionsAdvancements have been made in therapies to influence capsular formation around silicone implants. However, clinical validation remains limited due to small sample sizes and short study periods. ADMs and LTRAs appear most promising, warranting further long-term clinical studies to fully understand their potential benefits in improving breast implant biocompatibility.No Level AssignedThis journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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.