Comparison of Effects of Acellular Dermal Matrix and Latissimus Dorsi Muscle Flap on Radiation-induced Peri-implant Capsular Contracture in a Rabbit Model

Abstract

Background Capsular contracture of breast implants is a major complication in breast surgery. Clinically, covering a breast implant with acellular dermal matrix (ADM) or autologous tissue is considered to be the most effective technique to prevent capsular contracture. This study was designed to compare the protective effects of ADM and latissimus dorsi (LD) muscle flap placement on capsular contracture by increasing the rate of capsular contracture through controlled radiation exposure in a rabbit model.

Methods Twenty New Zealand white rabbits were divided into three groups. After the implant was placed beneath the pectoralis major muscle, the lateral third of the implant was left exposed in the control group (n = 6). In the ADM group (n = 7), the exposed implant was covered with AlloDerm. In the LD flap group (n = 7), the exposed implant was covered with a pedicled LD muscle flap. All groups were irradiated 3 weeks after implant insertion. After 6 months, peri-implant tissues were harvested and analyzed.

Results ADM showed markedly lower myofibroblast activity than the LD flap. However, transforming growth factor-β1 levels and the activity of collagen types I and III produced in fibroblasts were significantly lower in the ADM group than in the LD flap group.

Conclusion Based on the findings of our rabbit experiments, ADM is expected to have a comparative advantage in reducing the risk of capsular contracture compared to the LD flap.

Keywords

silicone breast implant - acellular dermal matrix - latissimus dorsi muscle flap - radiation-induced capsular contracture

Authors' Contributions

Conception and design: S.Y.J., H.K.K.

Acquisition of data: T.H.B., S.H.W., W.J.K.

Data analysis and interpretation: I.Y.A., S.H.K., M.K.K.

Visualization: I.Y.A., C.S.

Manuscript writing: All authors

Revising the content: S.Y.J., I.Y.A., H.K.K.

All authors have read and approved the final version of this manuscript.

Ethical Approval

This animal care and use protocol was reviewed and approved by the IACUC at Chung-Ang University (approval number 2017-00019).

Patient Consent

Not applicable.

Availability of Data and Materials

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Financial Disclosure

The authors have no financial interest in any of the products, devices, or drugs mentioned in this manuscript.

Publication History

Received: 09 August 2023

Accepted: 13 July 2024

Accepted Manuscript online:
17 July 2024

Article published online:
09 September 2024

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