Biocompatible Surface Coatings for Silicone-Based Implants
With the growing interest in beauty and antiaging, demands for plastic surgery are rapidly increasing worldwide. Breast augmentation is one of the most representative forms of plastic surgery accounting for 15% of all cosmetic surgical procedures. 1 Moreover, breast reconstruction is becoming increasingly important for patients who have had mastectomies to remove cancerous breast tissues. 2 In most cases, silicone-based bags filled with saline or silicone cohesive gel are used as the breast implants. 3 Both the silicone bags and the cohesive filling gels are made of poly(dimethylsiloxane) 1212(PDMS) with different crosslinking degrees (Fig. 40.1). PDMS has been used as the implantable materials due to its inert, malleable, and deformable characteristics. Although the breast tissue–like mechanical properties and the moderate price of the silicone implants generally satisfy the patients, infection during the surgical procedure and the limited biocompatibility of the silicone surface often induce dissatisfaction with severe side effects. Approximately 4.3%–20% of patients receive surgical intervention because of capsular contracture, hematoma/seroma, infection, asymmetry with displacement, rippling of skin, pain, and rupture. Among them, the most prominent complication is capsular contracture, which accounts for 16.2%–55% of all cases of revision surgery. 4 , 5–6 Structure of PDMS, the base material for silicone implants.