CC BY-NC 4.0 · Arch Plast Surg 2019; 46(02): 160-166
DOI: 10.5999/aps.2018.00864
Original Article

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

Plastic and Reconstructive Surgery Unit, Lerdsin Hospital, Ministry of Public Health, Bangkok, Thailand
,
Plastic and Reconstructive Surgery Unit, Lerdsin Hospital, Ministry of Public Health, Bangkok, Thailand
› Author Affiliations

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.

This article was presented at the International Aesthetic Conference of Chang Gung Memorial Hospital, on September 22–24, 2017, in Taipei, Thailand.




Publication History

Received: 13 July 2018

Accepted: 04 January 2019

Article published online:
03 April 2022

© 2019. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • REFERENCES

  • 1 Hiraga Y. Complications of augmentation rhinoplasty in the Japanese. Ann Plast Surg 1980; 4: 495-9
  • 2 Baker Jr JL. Augmentation mammaplasty. In: Owsley Jr JQ, Peterson RA. Symposium on aesthetic surgery of the breast. St. Louis: C.V. Mosby; 1978: 256-63
  • 3 Deva AK, Chang LC. Bacterial biofilm: a cause for accelerated capsular contracture?. Aesthet Surg J 1999; 19: 130-3
  • 4 Jung DH, Kim BR, Choi JY. et al. Gross and pathologic analysis of long-term silicone implants inserted into the human body for augmentation rhinoplasty: 221 revision cases. Plast Reconstr Surg 2007; 120: 1997-2003
  • 5 Kim YK, Shin S, Kang NH. et al. Contracted nose after silicone implantation: a new classification system and treatment algorithm. Arch Plast Surg 2017; 44: 59-64
  • 6 Dower R, Turner ML. Pilot study of timing of biofilm formation on closed suction wound drains. Plast Reconstr Surg 2012; 130: 1141-6
  • 7 Shah Z, Lehman Jr JA, Tan J. Does infection play a role in breast capsular contracture?. Plast Reconstr Surg 1981; 68: 34-42
  • 8 Tamboto H, Vickery K, Deva AK. Subclinical (biofilm) infection causes capsular contracture in a porcine model following augmentation mammaplasty. Plast Reconstr Surg 2010; 126: 835-42
  • 9 Pajkos A, Deva AK, Vickery K. et al. Detection of subclinical infection in significant breast implant capsules. Plast Reconstr Surg 2003; 111: 1605-11
  • 10 Tunney MM, Dunne N, Einarsson G. et al. Biofilm formation by bacteria isolated from retrieved failed prosthetic hip implants in an in vitro model of hip arthroplasty antibiotic prophylaxis. J Orthop Res 2007; 25: 2-10
  • 11 Vinh DC, Embil JM. Device-related infections: a review. J Long Term Eff Med Implants 2005; 15: 467-88
  • 12 Bergamini TM, Bandyk DF, Govostis D. et al. Infection of vascular prostheses caused by bacterial biofilms. J Vasc Surg 1988; 7: 21-30
  • 13 Rogers J, Norkett DI, Bracegirdle P. et al. Examination of biofilm formation and risk of infection associated with the use of urinary catheters with leg bags. J Hosp Infect 1996; 32: 105-15
  • 14 Tran PL, Huynh E, Pham P. et al. Organoselenium polymer inhibits biofilm formation in polypropylene contact lens case material. Eye Contact Lens 2017; 43: 110-5
  • 15 Walker TJ, Toriumi DM. Analysis of facial implants for bacterial biofilm formation using scanning electron microscopy. JAMA Facial Plast Surg 2016; 18: 299-304
  • 16 Hu H, Johani K, Almatroudi A. et al. Bacterial biofilm infection detected in breast implant-associated anaplastic large-cell lymphoma. Plast Reconstr Surg 2016; 137: 1659-69