The Effect of Suture Materials on the Development of Capsular Contracture in Silicone Implants.

[BACKGROUND] Capsular contracture leads to undesirable outcomes when using breast prostheses. Although implant characteristics and surgical techniques have been studied extensively, the impact of suture materials on capsule formation remains unclear.

[OBJECTIVES] The aim of the authors of this study is to evaluate the effects of different suture materials on capsular contracture development in a rat model with silicone implants.

[METHODS] The rats were divided into 5 groups. Silicone measuring 1.0 × 1.0 × 0.5 cm was implanted in the thoracodorsal region. The incisions were closed using poly(glycolide-co-lactide), polypropylene, polydioxanone, Glycomer 631, and polyglycolide-co-caprolactone in Groups 1 to 5, respectively. The capsule surrounding the implant was examined in histopathological specimens collected during the 12th week after implantation.

[RESULTS] Capsule thickness varied significantly among groups, with Group 1 exhibiting the highest mean thickness and Group 4 the lowest. Inflammation levels also differed, with Group 3 showing the highest proportion of moderate to severe inflammation, whereas Group 4 primarily exhibited mild inflammation. The type of inflammation varied, with Groups 3, 4, and 5 predominantly showing mixed-type inflammation. The presence of foreign body giant cells was highest in Groups 1 and 2, whereas Group 4 had the lowest. No significant differences were observed in hemosiderin presence, collagen organization, or myofibroblast density.

[CONCLUSIONS] In terms of the type and degree of inflammation, presence of foreign body giant cells, and average capsule thickness, Group 4 (Glycomer 631) suture had the best overall performance, and Group 1 (poly(glycolide-co-lactide)) performed the worst. Glycomer 631 sutures may reduce capsular contracture in silicone implant surgeries compared with other suture materials.