Arch Plast Surg.  2019 Mar;46(2):160-166. 10.5999/aps.2018.00864.

Analysis of subclinical infections and biofilm formation in cases of capsular contracture after silicone augmentation rhinoplasty: Prevalence and microbiological study

Affiliations
  • 1Plastic and Reconstructive Surgery Unit, Lerdsin Hospital, Ministry of Public Health, Bangkok, Thailand. add345@gmail.com

Abstract

BACKGROUND
Implant-related deformities in aesthetic rhinoplasty are a major problem for rhinoplasty surgeons. Capsular contracture is believed to be the pathological cause of delayed contour deformities, comparable to breast implant-related contracture. This study investigated the prevalence of bacterial biofilms and other epidemiological factors related to capsular contracture in cases of silicone augmentation rhinoplasty.
METHODS
Thirty-three patients who underwent corrective rhinoplasty due to a delayed contour deformity or aesthetic revision after implant rhinoplasty were studied from December 2014 to December 2016. All recruited patients received surgical correction by the authors. The patients were categorized by clinical severity into four grades. Demographic data and related confounding factors were recorded. Samples of capsular tissue and silicone removed from each patient were analyzed for the presence of a biofilm by ultrasonication with bacterial culture and scanning electron microscopy.
RESULTS
Thirty-three paired samples of capsular tissue and silicone implants from the study group were analyzed. Biofilms were detected in one of 10 subjects (10%) with grade 1 contracture, two of four (50%) with grade 2 contracture, 10 of 14 (71.40%) with grade 3 contracture, and four of five (80%) with grade 4 contracture (P<0.05). The organisms found were Staphylococcus epidermidis (47.10%), coagulase-negative staphylococci (35.30%), and Staphylococcus aureus (17.60%).
CONCLUSIONS
As with breast implant-related capsular contracture, silicone nasal augmentation deformities likely result from bacterial biofilms. We demonstrated the prevalence of biofilms in patients with various degrees of contracture. Implant type and operative technique seemed to have only vague correlations with biofilm presence.

Keyword

Rhinoplasty; Silicone; Biofilm

MeSH Terms

Asymptomatic Infections*
Biofilms*
Breast
Congenital Abnormalities
Contracture*
Humans
Microscopy, Electron, Scanning
Prevalence*
Rhinoplasty*
Silicon*
Silicones*
Staphylococcus aureus
Staphylococcus epidermidis
Surgeons
Silicon
Silicones
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