Polyglactin 910 (Vicryl)–Wrapped Implants to Improve Implant Stability
Tim Y. Li, Hector F. Salazar, Sophia Salingaros, Jini Jeon, Riley D. Mayne, Xue Dong, Jason A. SpectorIntroduction
Use of textured breast implants and tissue expanders has markedly declined due to their association with BIA-ALCL. Alternatives for stabilization such as ADM are costly, and suture tabs for expander anchoring can cause pain and anchor point failure with resultant implant malposition. This study aims to explore an alternative approach using Polyglactin 910 mesh (Vicryl woven mesh) to wrap and stabilize smooth-surface implants.
Methods
Miniature 2-mL breast implants were manufactured using polydimethylsiloxane. Vicryl woven mesh was used to wrap smooth implants, with comparison groups consisting of smooth and textured implants nonwrapped implants. Six sterilized implants from each group were implanted into subcutaneous pockets on the dorsa of Sprague-Dawley rats (n = 2 per rat). Animals were sacrificed after 4 and 12 weeks, and implant-capsule units were explanted for evaluation of positional stability, histology, and SEM.
Results
Vicryl-wrapped implants rotated 49 degrees less than smooth implants at 4 weeks and 76 degrees less at 12 weeks. Histology demonstrated partially dissolved Vicryl mesh in the wrapped group capsule at 4 weeks, with complete mesh degradation by 12 weeks. There were no significant differences in capsule thickness and collagen fiber density (percent area) between smooth and wrapped conditions. Although histologically similar to nonwrapped smooth implants, on higher magnification, SEM demonstrated a regular pattern of undulating microscopic projections in wrapped implant capsules, recapitulating the woven patterns of Vicryl mesh; smooth implant capsules were largely featureless.
Conclusions
Implants wrapped with fast-absorbing Vicryl mesh demonstrated improved stability, likely due to capsular microtopographic changes (seen only on SEM) induced by the presence of Vicryl mesh, resulting in increased frictional force between the implant surface and surrounding tissues. This study highlights the potential for using Vicryl mesh as an affordable temporary scaffold for stabilizing smooth implants and tissue expanders.