title: Characterization of Breast Implant Surfaces, Shapes, and Biomechanics: A Comparison of High Cohesive Anatomically Shaped Textured Silicone, Breast Implants from Three Different Manufacturers.
abstract: Several companies offer anatomically shaped breast implants but differences among manufacturers are often misunderstood. The shell texture is a crucial parameter for anatomically shaped implants to prevent rotation and to decrease the risk of capsular contracture, even though concerns have recently been raised concerning the complications associated with textured breast implants. The aim of this study was to characterize differences in terms of texture, cell adhesion, shape, and stiffness between some commonly used anatomically shaped implants from three different manufacturers.
  
  
  METHODS
  Five commercially available anatomically shaped breast implants from 3 different manufacturers (Allergan, Mentor, and Sebbin) were used. Scanning electron microscopy, X-ray microtomography, and scanning mechanical microscopy were used to characterize the shell texture. Human fibroblast adhesion onto the shells was evaluated. 3D models of the implants were obtained using CT-scan acquisitions to analyze their shape. Implant stiffness was evaluated using a tractiometer.
  
  
  RESULTS
  Major differences were observed in the topography of the textures of the shells, but this was not conveyed by a statistically significant fibroblast adhesion difference. However, fibroblasts adhered better on anatomically shaped textured implants than on smooth implants (p < 0.01). Our work pointed out differences in the Biocell® texture in comparison with older studies. The 3D analysis showed significant shape differences between the anatomically shaped implants of the 3 companies, despite similar dimensions. Implant stiffness was comparable among the 3 brands.
  
  
  CONCLUSIONS
  Each texture had its specific topography, and this work is the first description of Sebbin anatomic breast implant texturation. Moreover, major discrepancies were found in the analysis of the Biocell® texture when comparing our results with previous reports. These differences may have clinical implications and are discussed. This study also highlighted major shape differences among breast implants from different manufacturers, which is quite counterintuitive. The clinical impact of these differences however needs further investigation.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
authors.affiliation: Aesthetic Plastic Reconstructive Unit/CHU TENON PARIS -APHP, Université Pierre et Marie Curie Paris VI, 4 rue de la Chine, Paris, France. drmichaelatlan@gmail.com.|Université Pierre et Marie Curie, UPMC PARIS VI, 91 boulevard de l'hôpital, 75013, Paris, France. drmichaelatlan@gmail.com.|Institut Universitaire du Cancer, UPMC, 91 boulevard de l'hôpital, 75013, Paris, France. drmichaelatlan@gmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Atlan
authors.affiliation: Laboratoire d'automatique, de mécanique et d'informatique industrielles et humaines, Valenciennes, France.
authors.forename: Maxence
authors.initials: M
authors.lastname: Bigerelle
authors.affiliation: Laboratoire ERRMECe, EA 1391, 95302, Cergy-Pontoise Cedex, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Larreta-garde
authors.affiliation: Laboratoire ERRMECe, EA 1391, 95302, Cergy-Pontoise Cedex, France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Hindié
authors.affiliation: Akademikliniken, Storängsvägen 10, 11542, Stockholm, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Hedén
mesh_terms: D001696:Biomechanical Phenomena; D018427:Breast Implants; D008422:Materials Testing; D011474:Prosthesis Design; D020034:Silicone Gels
chemical_list: D020034:Silicone Gels
keywords: Anatomically shaped breast implant; Biocell; Cell adhesion; Siltex; Stiffness; Texture