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Biomechanical Principles of Breast Implants and Current State of Research in Soft Tissue Engineering for Cosmetic Breast Augmentation

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  • Breast Surgery
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Abstract

Currently there are limited implant-based options for cosmetic breast augmentation, and problems associated with those have been increasingly appreciated, most commonly capsular contracture, which occurs due to a chronic foreign body reaction against non-degradable implant materials such as silicone and polyurethane leading to scar tissue formation, pain, and deformity. The underlying biomechanical concepts with implants create a reciprocal stress–strain relationship with local tissue, whilst acting as a deforming force. This means that with time, as the implant continues to have an effect on surrounding tissue the implant and host’s biomechanical properties diverge, making malposition, asymmetry, and other complications more likely. Research directed towards development of alternative therapies based on tissue engineering and regenerative medicine seeks to optimize new tissue formation through modulation of tissue progenitors and facilitating tissue regeneration. Scaffolds can guide the process of new tissue formation by providing both an implant surface and a three-dimensional space that promotes the development of a microenvironment that guides attachment, migration, proliferation, and differentiation of connective tissue progenitors. Important to scaffold design are the architecture, surface chemistry, mechanical properties, and biomaterial used. Scaffolds provide a void in which vascularization, new tissue formation, and remodelling can sequentially occur. They provide a conduit for delivery of the different cell types required for tissue regeneration into a graft site, facilitating their retention and distribution. Whilst recent research from a small number of groups is promising, there are still ongoing challenges to achieving clinical translation. This article summarizes the biomechanical principles of breast implants, how these impact outcomes, and progress in scaffold-guided tissue engineering approaches to cosmetic breast augmentation.

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Authors and Affiliations

  1. Centre for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, QLD, 4000, Australia

    Jan Janzekovic, Tim Peltz, Tim Brown & Dietmar W. Hutmacher

  2. Plastic and Reconstructive Surgery, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, QLD, 4102, Australia

    Jan Janzekovic & Michael Wagels

  3. Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia

    Jeremy Hunt & Tim Peltz

  4. St Luke’s and Prince of Wales Hospital Plastic Surgery Research Group, Potts Point, NSW, 2011, Australia

    Tim Peltz & Michael Wagels

  5. Plastic Surgeon in Private Practice in Melbourne, 40-42 Clyde Road, Suite 2, Berwick, VIC, 3806, Australia

    Tim Brown

  6. School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, Brisbane, QLD, 4000, Australia

    Tim Brown & Dietmar W. Hutmacher

  7. School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4000, Australia

    Dietmar W. Hutmacher

  8. ARC ITTC in Additive Biomanufacturing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, 4000, Australia

    Dietmar W. Hutmacher

Authors
  1. Jan Janzekovic
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  2. Jeremy Hunt
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  3. Tim Peltz
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  4. Michael Wagels
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  5. Tim Brown
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  6. Dietmar W. Hutmacher
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Correspondence to Tim Brown.

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Ethical Standards

Dietmar W Hutmacher is a founder and shareholder of BellaSeno GmbH. No third-party financial or material support was sought to produce this manuscript. Dr Brown is a paid consultant for BelaSeno Pty Ltd. The studies undertaken and reported in this article by the authors involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All applicable international, national, and/or institutional guidelines for the care and use of animals were followed in studies report in the article that were undertaken by the authors.

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Janzekovic, J., Hunt, J., Peltz, T. et al. Biomechanical Principles of Breast Implants and Current State of Research in Soft Tissue Engineering for Cosmetic Breast Augmentation. Aesth Plast Surg 46, 1–10 (2022). https://doi.org/10.1007/s00266-021-02559-y

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  • DOI: https://doi.org/10.1007/s00266-021-02559-y

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