Skip to main content
Top
Published in: Aesthetic Plastic Surgery 4/2019

Open Access 01-08-2019 | Breast Augmentation | Original Article

PCR Characterization of Microbiota on Contracted and Non-Contracted Breast Capsules

Authors: Yara Bachour, Linda Poort, Stephan P. Verweij, Gijs van Selms, Hay A. H. Winters, Marco J. P. F. Ritt, Frank B. Niessen, Andries E. Budding

Published in: Aesthetic Plastic Surgery | Issue 4/2019

Login to get access

Abstract

Background

The aetiology of capsular contracture around breast implants remains unclear. The leading theory is that a subclinical infection around the implant plays a role in the development of capsular contractions. Several studies found associations between the presence of bacteria and the occurrence of capsular contraction. However, it is unclear whether detected bacteria originate from the breast capsule, breast glandular tissue or skin contamination. Moreover, this has never been investigated with molecular techniques. The aim of this study was to assess the bacterial microbiota on breast capsules, glandular tissue and skin using a highly sensitive PCR assay.

Materials and Methods

Fifty breast capsules were collected during implant removal or replacement. Ten specimens of glandular breast tissue and breast skin were collected in females who were undergoing reduction mammoplasty. A sample specimen (4 mm) was sterilely obtained from all tissues. All specimens were analysed by IS-pro, a 16S–23S interspace region-based PCR assay.

Results

Low numbers of Staphylococcus spp. (four species in four capsules) were found on breast capsules. There was no difference in bacterial presence between normal and contracted capsules. The skin of the breast-harboured Streptococcus spp. and Staphylococcus spp. while the glandular tissue was sterile.

Conclusion

The low numbers of bacteria found on the capsules are most likely caused by contamination during capsule removal. More and larger studies are needed to investigate the bacterial presence on breast capsules using a PCR assay. This is the first study in which breast capsules have been studied using a highly sensitive PCR assay.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. 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.
Literature
1.
go back to reference Spear SL, Murphy DK, Slicton A et al (2007) Inamed silicone breast implant core study results at 6 years. Plast Reconstr Surg 120:8S–16SPubMed Spear SL, Murphy DK, Slicton A et al (2007) Inamed silicone breast implant core study results at 6 years. Plast Reconstr Surg 120:8S–16SPubMed
2.
go back to reference Domanskis E, Owsley JQJ (1976) Histological investigation of the etiology of capsule contracture following augmentation mammaplasty. Plast Reconstr Surg 58:689–693PubMed Domanskis E, Owsley JQJ (1976) Histological investigation of the etiology of capsule contracture following augmentation mammaplasty. Plast Reconstr Surg 58:689–693PubMed
3.
go back to reference Gayou R, Rudolph R (1979) Capsular contraction around silicone mammary prostheses. Ann Plast Surg 2:62–71PubMed Gayou R, Rudolph R (1979) Capsular contraction around silicone mammary prostheses. Ann Plast Surg 2:62–71PubMed
4.
go back to reference Nemecek JA, Young VL (1993) How safe are silicone breast implants? South Med J 86:932–944PubMed Nemecek JA, Young VL (1993) How safe are silicone breast implants? South Med J 86:932–944PubMed
5.
go back to reference Henriksen TF, Holmich LR, Fryzek JP et al (2003) Incidence and severity of short-term complications after breast augmentation: results from a nationwide breast implant registry. Ann Plast Surg 51:531–539PubMed Henriksen TF, Holmich LR, Fryzek JP et al (2003) Incidence and severity of short-term complications after breast augmentation: results from a nationwide breast implant registry. Ann Plast Surg 51:531–539PubMed
6.
go back to reference Stevens WG, Harrington J, Alizadeh K et al (2012) Five-year follow-up data from the U.S. clinical trial for Sientra’s U.S. Food and Drug Administration-approved Silimed(R) brand round and shaped implants with high-strength silicone gel. Plast Reconstr Surg 130:973–981PubMed Stevens WG, Harrington J, Alizadeh K et al (2012) Five-year follow-up data from the U.S. clinical trial for Sientra’s U.S. Food and Drug Administration-approved Silimed(R) brand round and shaped implants with high-strength silicone gel. Plast Reconstr Surg 130:973–981PubMed
7.
go back to reference Codner MA, Mejia JD, Locke MB et al (2011) A 15-year experience with primary breast augmentation. Plast Reconstr Surg 127:1300–1310PubMed Codner MA, Mejia JD, Locke MB et al (2011) A 15-year experience with primary breast augmentation. Plast Reconstr Surg 127:1300–1310PubMed
8.
go back to reference Bengtson BP, Van Natta BW, Murphy DK et al (2007) Style 410 highly cohesive silicone breast implant core study results at 3 years. Plast Reconstr Surg 120:40S–48SPubMed Bengtson BP, Van Natta BW, Murphy DK et al (2007) Style 410 highly cohesive silicone breast implant core study results at 3 years. Plast Reconstr Surg 120:40S–48SPubMed
9.
go back to reference Spear SL, Murphy DK (2014) Natrelle round silicone breast implants: core study results at 10 years. Plast Reconstr Surg 133:1354–1361PubMedPubMedCentral Spear SL, Murphy DK (2014) Natrelle round silicone breast implants: core study results at 10 years. Plast Reconstr Surg 133:1354–1361PubMedPubMedCentral
10.
go back to reference Spear SL, Murphy DK, Slicton A et al (2007) Inamed silicone breast implant core study results at 6 years. Plast Reconstr Surg 120:8S–16SPubMed Spear SL, Murphy DK, Slicton A et al (2007) Inamed silicone breast implant core study results at 6 years. Plast Reconstr Surg 120:8S–16SPubMed
11.
go back to reference Holmich LR, Breiting VB, Fryzek JP et al (2007) Long-term cosmetic outcome after breast implantation. Ann Plast Surg 59:597–604PubMed Holmich LR, Breiting VB, Fryzek JP et al (2007) Long-term cosmetic outcome after breast implantation. Ann Plast Surg 59:597–604PubMed
12.
go back to reference Marques M, Brown SA, Oliveira I et al (2010) Long-term follow-up of breast capsule contracture rates in cosmetic and reconstructive cases. Plast Reconstr Surg 126:769–778PubMed Marques M, Brown SA, Oliveira I et al (2010) Long-term follow-up of breast capsule contracture rates in cosmetic and reconstructive cases. Plast Reconstr Surg 126:769–778PubMed
13.
go back to reference Baker JL Jr, Bartels RJ, Douglas WM (1976) Closed compression technique for rupturing a contracted capsule around a breast implant. Plast Reconstr Surg 58:137–141PubMed Baker JL Jr, Bartels RJ, Douglas WM (1976) Closed compression technique for rupturing a contracted capsule around a breast implant. Plast Reconstr Surg 58:137–141PubMed
14.
go back to reference Bachour Y, Verweij SP, Gibbs S et al (2018) The aetiopathogenesis of capsular contracture: a systematic review of the literature. J Plast Reconstr Aesthet Surg 71:307–317PubMed Bachour Y, Verweij SP, Gibbs S et al (2018) The aetiopathogenesis of capsular contracture: a systematic review of the literature. J Plast Reconstr Aesthet Surg 71:307–317PubMed
15.
go back to reference Bachour Y, Bargon CA, de Blok CJM et al (2018) Risk factors for developing capsular contracture in women after breast implant surgery: a systematic review of the literature. J Plast Reconstr Aesthet Surg 71:e29–e48PubMed Bachour Y, Bargon CA, de Blok CJM et al (2018) Risk factors for developing capsular contracture in women after breast implant surgery: a systematic review of the literature. J Plast Reconstr Aesthet Surg 71:e29–e48PubMed
16.
go back to reference Burkhardt BR, Fried M, Schnur PL et al (1981) Capsules, infection, and intraluminal antibiotics. Plast Reconstr Surg 68:43–49PubMed Burkhardt BR, Fried M, Schnur PL et al (1981) Capsules, infection, and intraluminal antibiotics. Plast Reconstr Surg 68:43–49PubMed
17.
go back to reference Netscher DT, Weizer G, Wigoda P et al (1995) Clinical relevance of positive breast periprosthetic cultures without overt infection. Plast Reconstr Surg 96:1125–1129PubMed Netscher DT, Weizer G, Wigoda P et al (1995) Clinical relevance of positive breast periprosthetic cultures without overt infection. Plast Reconstr Surg 96:1125–1129PubMed
18.
go back to reference Dobke MK, Svahn JK, Vastine VL et al (1995) Characterization of microbial presence at the surface of silicone mammary implants. Ann Plast Surg 34:563–569PubMed Dobke MK, Svahn JK, Vastine VL et al (1995) Characterization of microbial presence at the surface of silicone mammary implants. Ann Plast Surg 34:563–569PubMed
19.
go back to reference Shah Z, Lehman JAJ, Tan J (1981) Does infection play a role in breast capsular contracture? Plast Reconstr Surg 68:34–42PubMed Shah Z, Lehman JAJ, Tan J (1981) Does infection play a role in breast capsular contracture? Plast Reconstr Surg 68:34–42PubMed
20.
go back to reference Mirzabeigi MN, Mericli AF, Ortlip T et al (2012) Evaluating the role of postoperative prophylactic antibiotics in primary and secondary breast augmentation: a retrospective review. Aesthet Surg J 32:61–68PubMed Mirzabeigi MN, Mericli AF, Ortlip T et al (2012) Evaluating the role of postoperative prophylactic antibiotics in primary and secondary breast augmentation: a retrospective review. Aesthet Surg J 32:61–68PubMed
21.
go back to reference Budding AE, Hoogewerf M, Vandenbroucke-Grauls CM et al (2016) Automated Broad-Range Molecular Detection of Bacteria in Clinical Samples. J Clin Microbiol 54:934–943PubMedPubMedCentral Budding AE, Hoogewerf M, Vandenbroucke-Grauls CM et al (2016) Automated Broad-Range Molecular Detection of Bacteria in Clinical Samples. J Clin Microbiol 54:934–943PubMedPubMedCentral
22.
go back to reference Sontakke S, Cadenas MB, Maggi RG et al (2009) Use of broad range16S rDNA PCR in clinical microbiology. J Microbiol Methods 76:217–225PubMed Sontakke S, Cadenas MB, Maggi RG et al (2009) Use of broad range16S rDNA PCR in clinical microbiology. J Microbiol Methods 76:217–225PubMed
23.
go back to reference Song YG, Shim SG, Kim KM et al (2014) Profiling of the bacteria responsible for pyogenic liver abscess by 16S rRNA gene pyrosequencing. J Microbiol 52:504–509PubMed Song YG, Shim SG, Kim KM et al (2014) Profiling of the bacteria responsible for pyogenic liver abscess by 16S rRNA gene pyrosequencing. J Microbiol 52:504–509PubMed
24.
go back to reference Budding AE, Grasman ME, Lin F et al (2010) IS-pro: high-throughput molecular fingerprinting of the intestinal microbiota. FASEB J 24:4556–4564PubMed Budding AE, Grasman ME, Lin F et al (2010) IS-pro: high-throughput molecular fingerprinting of the intestinal microbiota. FASEB J 24:4556–4564PubMed
25.
go back to reference Rudolph R, Woodward M (1983) Absence of visible bacteria in capsules around silicone breast implants. Plast Reconstr Surg 72:32–35PubMed Rudolph R, Woodward M (1983) Absence of visible bacteria in capsules around silicone breast implants. Plast Reconstr Surg 72:32–35PubMed
26.
go back to reference Virden CP, Dobke MK, Stein P et al (1992) Subclinical infection of the silicone breast implant surface as a possible cause of capsular contracture. Aesthetic Plast Surg 16:173–179PubMed Virden CP, Dobke MK, Stein P et al (1992) Subclinical infection of the silicone breast implant surface as a possible cause of capsular contracture. Aesthetic Plast Surg 16:173–179PubMed
27.
go back to reference Schreml S, Heine N, Eisenmann-Klein M et al (2007) Bacterial colonization is of major relevance for high-grade capsular contracture after augmentation mammaplasty. Ann Plast Surg 59:126–130PubMed Schreml S, Heine N, Eisenmann-Klein M et al (2007) Bacterial colonization is of major relevance for high-grade capsular contracture after augmentation mammaplasty. Ann Plast Surg 59:126–130PubMed
28.
go back to reference Carlesimo B, Cigna E, Fino P et al (2009) Antibiotic therapy of transaxillary augmentation mammoplasty. Vivo 23:357–362 Carlesimo B, Cigna E, Fino P et al (2009) Antibiotic therapy of transaxillary augmentation mammoplasty. Vivo 23:357–362
29.
go back to reference Pfeiffer P, Jorgensen S, Kristiansen TB et al (2009) Protective effect of topical antibiotics in breast augmentation. Plast Reconstr Surg 124:629–634PubMed Pfeiffer P, Jorgensen S, Kristiansen TB et al (2009) Protective effect of topical antibiotics in breast augmentation. Plast Reconstr Surg 124:629–634PubMed
30.
go back to reference Burkhardt BR, Dempsey PD, Schnur PL et al (1986) Capsular contracture: a prospective study of the effect of local antibacterial agents. Plast Reconstr Surg 77:919–932PubMed Burkhardt BR, Dempsey PD, Schnur PL et al (1986) Capsular contracture: a prospective study of the effect of local antibacterial agents. Plast Reconstr Surg 77:919–932PubMed
31.
go back to reference Burkhardt BR, Eades E (1995) The effect of Biocell texturing and povidone-iodine irrigation on capsular contracture around saline-inflatable breast implants. Plast Reconstr Surg 96:1317–1325PubMed Burkhardt BR, Eades E (1995) The effect of Biocell texturing and povidone-iodine irrigation on capsular contracture around saline-inflatable breast implants. Plast Reconstr Surg 96:1317–1325PubMed
32.
go back to reference Adams WPJ, Rios JL, Smith SJ (2006) Enhancing patient outcomes in aesthetic and reconstructive breast surgery using triple antibiotic breast irrigation: six-year prospective clinical study. Plast Reconstr Surg 118:46S–52SPubMed Adams WPJ, Rios JL, Smith SJ (2006) Enhancing patient outcomes in aesthetic and reconstructive breast surgery using triple antibiotic breast irrigation: six-year prospective clinical study. Plast Reconstr Surg 118:46S–52SPubMed
33.
go back to reference Wiener TC (2007) The role of betadine irrigation in breast augmentation. Plast Reconstr Surg 119:12–15PubMed Wiener TC (2007) The role of betadine irrigation in breast augmentation. Plast Reconstr Surg 119:12–15PubMed
34.
go back to reference Giordano S, Peltoniemi H, Lilius P et al (2013) Povidone-iodine combined with antibiotic topical irrigation to reduce capsular contracture in cosmetic breast augmentation: a comparative study. Aesthet Surg J 33:675–680PubMed Giordano S, Peltoniemi H, Lilius P et al (2013) Povidone-iodine combined with antibiotic topical irrigation to reduce capsular contracture in cosmetic breast augmentation: a comparative study. Aesthet Surg J 33:675–680PubMed
35.
go back to reference Drinane JJ, Kortes MJ, Bergman RS et al (2016) Evaluation of antibiotic irrigation versus saline irrigation in reducing the long-term incidence and severity of capsular contraction after primary augmentation mammoplasty. Ann Plast Surg 77:32–36PubMed Drinane JJ, Kortes MJ, Bergman RS et al (2016) Evaluation of antibiotic irrigation versus saline irrigation in reducing the long-term incidence and severity of capsular contraction after primary augmentation mammoplasty. Ann Plast Surg 77:32–36PubMed
37.
go back to reference Rogers KL, Fey PD, Rupp ME (2009) Coagulase-negative staphylococcal infections. Infect Dis Clin North Am 23:73–98PubMed Rogers KL, Fey PD, Rupp ME (2009) Coagulase-negative staphylococcal infections. Infect Dis Clin North Am 23:73–98PubMed
38.
go back to reference Ziebuhr W, Hennig S, Eckart M et al (2006) Nosocomial infections by Staphylococcus epidermidis: how a commensal bacterium turns into a pathogen. Int J Antimicrob Agents 28(Suppl 1):S14–S20PubMed Ziebuhr W, Hennig S, Eckart M et al (2006) Nosocomial infections by Staphylococcus epidermidis: how a commensal bacterium turns into a pathogen. Int J Antimicrob Agents 28(Suppl 1):S14–S20PubMed
39.
go back to reference Ransjo U, Asplund OA, Gylbert L et al (1985) Bacteria in the female breast. Scand J Plast Reconstr Surg 19:87–89PubMed Ransjo U, Asplund OA, Gylbert L et al (1985) Bacteria in the female breast. Scand J Plast Reconstr Surg 19:87–89PubMed
40.
go back to reference Thornton JW, Argenta LC, McClatchey KD et al (1988) Studies on the endogenous flora of the human breast. Ann Plast Surg 20:39–42PubMed Thornton JW, Argenta LC, McClatchey KD et al (1988) Studies on the endogenous flora of the human breast. Ann Plast Surg 20:39–42PubMed
41.
go back to reference Bartsich S, Ascherman JA, Whittier S et al (2011) The breast: a clean-contaminated surgical site. Aesthet Surg J 31:802–806PubMed Bartsich S, Ascherman JA, Whittier S et al (2011) The breast: a clean-contaminated surgical site. Aesthet Surg J 31:802–806PubMed
42.
go back to reference Xuan C, Shamonki JM, Chung A et al (2014) Microbial dysbiosis is associated with human breast cancer. PLoS ONE 9:e83744PubMedPubMedCentral Xuan C, Shamonki JM, Chung A et al (2014) Microbial dysbiosis is associated with human breast cancer. PLoS ONE 9:e83744PubMedPubMedCentral
43.
go back to reference Urbaniak C, Cummins J, Brackstone M et al (2014) Microbiota of human breast tissue. Appl Environ Microbiol 80:3007–3014PubMedPubMedCentral Urbaniak C, Cummins J, Brackstone M et al (2014) Microbiota of human breast tissue. Appl Environ Microbiol 80:3007–3014PubMedPubMedCentral
44.
go back to reference Urbaniak C, Gloor GB, Brackstone M et al (2016) The microbiota of breast tissue and its association with breast cancer. Appl Environ Microbiol 82:5039–5048PubMedPubMedCentral Urbaniak C, Gloor GB, Brackstone M et al (2016) The microbiota of breast tissue and its association with breast cancer. Appl Environ Microbiol 82:5039–5048PubMedPubMedCentral
45.
go back to reference Hieken TJ, Chen J, Hoskin TL et al (2016) The microbiome of aseptically collected human breast tissue in benign and malignant disease. Sci Rep 6:30751PubMedPubMedCentral Hieken TJ, Chen J, Hoskin TL et al (2016) The microbiome of aseptically collected human breast tissue in benign and malignant disease. Sci Rep 6:30751PubMedPubMedCentral
46.
go back to reference Jia HP, Starner T, Ackermann M et al (2001) Abundant human beta-defensin-1 expression in milk and mammary gland epithelium. J Pediatr 138:109–112PubMed Jia HP, Starner T, Ackermann M et al (2001) Abundant human beta-defensin-1 expression in milk and mammary gland epithelium. J Pediatr 138:109–112PubMed
47.
go back to reference Tunzi CR, Harper PA, Bar-Oz B et al (2000) Beta-defensin expression in human mammary gland epithelia. Pediatr Res 48:30–35PubMed Tunzi CR, Harper PA, Bar-Oz B et al (2000) Beta-defensin expression in human mammary gland epithelia. Pediatr Res 48:30–35PubMed
48.
go back to reference Murakami M, Dorschner RA, Stern LJ et al (2005) Expression and secretion of cathelicidin antimicrobial peptides in murine mammary glands and human milk. Pediatr Res 57:10–15PubMed Murakami M, Dorschner RA, Stern LJ et al (2005) Expression and secretion of cathelicidin antimicrobial peptides in murine mammary glands and human milk. Pediatr Res 57:10–15PubMed
49.
go back to reference Hameed MR, Erlandson R, Rosen PP (1995) Capsular synovial-like hyperplasia around mammary implants similar to detritic synovitis. A morphologic and immunohistochemical study of 15 cases. Am J Surg Pathol 19:433–438PubMed Hameed MR, Erlandson R, Rosen PP (1995) Capsular synovial-like hyperplasia around mammary implants similar to detritic synovitis. A morphologic and immunohistochemical study of 15 cases. Am J Surg Pathol 19:433–438PubMed
50.
go back to reference Kamel M, Protzner K, Fornasier V et al (2001) The peri-implant breast capsule: an immunophenotypic study of capsules taken at explantation surgery. J Biomed Mater Res 58:88–96PubMed Kamel M, Protzner K, Fornasier V et al (2001) The peri-implant breast capsule: an immunophenotypic study of capsules taken at explantation surgery. J Biomed Mater Res 58:88–96PubMed
51.
go back to reference Prantl L, Angele P, Schreml S et al (2006) Determination of serum fibrosis indexes in patients with capsular contracture after augmentation with smooth silicone gel implants. Plast Reconstr Surg 118:224–229PubMed Prantl L, Angele P, Schreml S et al (2006) Determination of serum fibrosis indexes in patients with capsular contracture after augmentation with smooth silicone gel implants. Plast Reconstr Surg 118:224–229PubMed
52.
go back to reference Prantl L, Schreml S, Fichtner-Feigl S et al (2007) Clinical and morphological conditions in capsular contracture formed around silicone breast implants. Plast Reconstr Surg 120:275–284PubMed Prantl L, Schreml S, Fichtner-Feigl S et al (2007) Clinical and morphological conditions in capsular contracture formed around silicone breast implants. Plast Reconstr Surg 120:275–284PubMed
53.
go back to reference Tan KT, Wijeratne D, Shih B et al (2010) Tumour necrosis factor-alpha expression is associated with increased severity of periprosthetic breast capsular contracture. Eur Surg Res 45:327–332PubMed Tan KT, Wijeratne D, Shih B et al (2010) Tumour necrosis factor-alpha expression is associated with increased severity of periprosthetic breast capsular contracture. Eur Surg Res 45:327–332PubMed
54.
go back to reference Tan KT, Baildam AD, Juma A et al (2011) Hyaluronan, TSG-6, and inter-alpha-inhibitor in periprosthetic breast capsules: reduced levels of free hyaluronan and TSG-6 expression in contracted capsules. Aesthet Surg J 31:47–55PubMedPubMedCentral Tan KT, Baildam AD, Juma A et al (2011) Hyaluronan, TSG-6, and inter-alpha-inhibitor in periprosthetic breast capsules: reduced levels of free hyaluronan and TSG-6 expression in contracted capsules. Aesthet Surg J 31:47–55PubMedPubMedCentral
55.
go back to reference Kyle DJT, Harvey AG, Shih B et al (2013) Identification of molecular phenotypic descriptors of breast capsular contracture formation using informatics analysis of the whole genome transcriptome. Wound Repair Regen 21:762–769PubMed Kyle DJT, Harvey AG, Shih B et al (2013) Identification of molecular phenotypic descriptors of breast capsular contracture formation using informatics analysis of the whole genome transcriptome. Wound Repair Regen 21:762–769PubMed
56.
go back to reference Bui JM, Perry T, Ren CD et al (2015) Histological characterization of human breast implant capsules. Aesthetic Plast Surg 39:306–315PubMedPubMedCentral Bui JM, Perry T, Ren CD et al (2015) Histological characterization of human breast implant capsules. Aesthetic Plast Surg 39:306–315PubMedPubMedCentral
57.
go back to reference Granchi D, Cavedagna D, Ciapetti G et al (1995) Silicone breast implants: the role of immune system on capsular contracture formation. J Biomed Mater Res 29:197–202PubMed Granchi D, Cavedagna D, Ciapetti G et al (1995) Silicone breast implants: the role of immune system on capsular contracture formation. J Biomed Mater Res 29:197–202PubMed
58.
go back to reference Prantl L, Poppl N, Horvat N et al (2005) Serologic and histologic findings in patients with capsular contracture after breast augmentation with smooth silicone gel implants: is serum hyaluronan a potential predictor? Aesthetic Plast Surg 29:510–518PubMed Prantl L, Poppl N, Horvat N et al (2005) Serologic and histologic findings in patients with capsular contracture after breast augmentation with smooth silicone gel implants: is serum hyaluronan a potential predictor? Aesthetic Plast Surg 29:510–518PubMed
59.
go back to reference Prantl L, Fichtner-Feigl S, Hofstaedter F et al (2008) Flow cytometric analysis of peripheral blood lymphocyte subsets in patients with silicone breast implants. Plast Reconstr Surg 121:25–30PubMed Prantl L, Fichtner-Feigl S, Hofstaedter F et al (2008) Flow cytometric analysis of peripheral blood lymphocyte subsets in patients with silicone breast implants. Plast Reconstr Surg 121:25–30PubMed
61.
go back to reference Namnoum JD, Largent J, Kaplan HM et al (2013) Primary breast augmentation clinical trial outcomes stratified by surgical incision, anatomical placement and implant device type. J Plast Reconstr Aesthet Surg 66:1165–1172PubMed Namnoum JD, Largent J, Kaplan HM et al (2013) Primary breast augmentation clinical trial outcomes stratified by surgical incision, anatomical placement and implant device type. J Plast Reconstr Aesthet Surg 66:1165–1172PubMed
62.
go back to reference Largent JA, Reisman NR, Kaplan HM et al (2013) Clinical trial outcomes of high- and extra high-profile breast implants. Aesthet Surg J 33:529–539PubMed Largent JA, Reisman NR, Kaplan HM et al (2013) Clinical trial outcomes of high- and extra high-profile breast implants. Aesthet Surg J 33:529–539PubMed
63.
go back to reference Jacobson JM, Gatti ME, Schaffner AD et al (2012) Effect of incision choice on outcomes in primary breast augmentation. Aesthet Surg J 32:456–462PubMed Jacobson JM, Gatti ME, Schaffner AD et al (2012) Effect of incision choice on outcomes in primary breast augmentation. Aesthet Surg J 32:456–462PubMed
64.
go back to reference Kulmala I, McLaughlin JK, Pakkanen M et al (2004) Local complications after cosmetic breast implant surgery in Finland. Ann Plast Surg 53:413–419PubMed Kulmala I, McLaughlin JK, Pakkanen M et al (2004) Local complications after cosmetic breast implant surgery in Finland. Ann Plast Surg 53:413–419PubMed
65.
go back to reference Hakelius L, Ohlsen L (1992) A clinical comparison of the tendency to capsular contracture between smooth and textured gel-filled silicone mammary implants. Plast Reconstr Surg 90:247–254PubMed Hakelius L, Ohlsen L (1992) A clinical comparison of the tendency to capsular contracture between smooth and textured gel-filled silicone mammary implants. Plast Reconstr Surg 90:247–254PubMed
66.
go back to reference Kjoller K, Holmich LR, Jacobsen PH et al (2001) Capsular contracture after cosmetic breast implant surgery in Denmark. Ann Plast Surg 47:359–366PubMed Kjoller K, Holmich LR, Jacobsen PH et al (2001) Capsular contracture after cosmetic breast implant surgery in Denmark. Ann Plast Surg 47:359–366PubMed
Metadata
Title
PCR Characterization of Microbiota on Contracted and Non-Contracted Breast Capsules
Authors
Yara Bachour
Linda Poort
Stephan P. Verweij
Gijs van Selms
Hay A. H. Winters
Marco J. P. F. Ritt
Frank B. Niessen
Andries E. Budding
Publication date
01-08-2019
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 4/2019
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-019-01383-9

Other articles of this Issue 4/2019

Aesthetic Plastic Surgery 4/2019 Go to the issue