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Motiva : Reducing
Capsular Contracture

Believing Is Achieving

SPIRAN supports innovative operative strategies to reduce the risk of breast implant bacterial contamination and help reduce incidence of Capsular Contracture

Capsular Contracture

Implant surface design has been shown to impact the incidence and severity of capsular contracture.


Attempts to Control Encapsulation

Past breast implant surface designs were developed in an attempt to control the encapsulation of the implant in the hope of reducing the incidence of capsular contracture and attempting to influence the way the capsule forms. The fibrotic capsule is the end point of an inflammatory foreign body response.   Polyurethane coatings allowed ingrowth of the fibrotic capsule breaking up the vectors of contractile forces, thus preventing contracture of the implant capsule.  This texturing was then mimicked by imprinting or salt loss techniques.   Even though capsular contracture rates were reduced compared to smooth implants in the subglandular plane 7they are still significantly high as these technologies have been developed to modify not prevent the mature fibrotic response.  Of recent times concerns have arisen with more aggressive texturing being associated with periprosthetic seromas, double capsules8,9 and the rare ALCL 10,11,12


Motiva TrueInnovation : Biocompatibility

The Nano Silk Surface matrix by Motiva is a new generation implant surface design.  It has been developed to reduce the body’s immune foreign body response and inflammatory cascade by being more biocompatible with the body.  A growing volume of published studies demonstrate how modifying the surface of any implant at a nano level will modify cellular behaviours13.   Thus the surface intervenes at the beginning of the inflammatory process, before the fibrosis occurs.   Cells will recognise Irregular topographies below 50 microns (nano-surface)   At this magnification the walls of the ‘textured’ and smooth implants all look very similar: smooth, and will proceed with the inflammatory foreign body response.   This biotechnology of nanosurface topography has been interwoven into the innovative technology of Motiva Breast Implants resulting in a capsular contracture rate of less than 1%.


Other factors have also been implicated in the development of the problems we see with aggressively textured implants. They include silicone particles, friction and biofilm.   The negative imprint technology avoids free particles and the surface has a low friction coefficient.   Studies have also shown that most macro-textured implants develop a significantly higher load of bacterial biofilm in comparison with smooth implants and in this regard the silk surface has a lower risk and behaves nearly like a smooth implant in animal studies.  This chronic inflammation has also been implicated in the development of ALCL12,14


Addressing Real Concerns

Motiva Silk Surface Nano Technology has the potential to address the concerns of capsular contracture due to its unique biocompatibility and low frictional properties. (Motiva Biocompatibility Testing Summary).  By combining Motiva Nano-Technology and components of the 14-point plan; surgeons can have greater confidence that they are controlling as much as they can, in order to reduce the potential risks of bacterial contamination and the body’s immune response to the insertion of breast implants and associated issues.

For More Information

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7 Wong CH, Samuel M, Tan BK, Song C. Capsular contracture in subglandular breast augmentation with textured versus smooth breast implants: a systematic review. Plast Reconstr Surg. 2006 Oct; 118(5):1224-36. Review. PubMed PMID: 17016195
8 Hall-Findlay  EJ.  Breast  implant  complication  review: double  capsules and  late seromas.  Plast Reconstr  Surg.  2011  Jan;127(1):56-66.  doi:  10.1097/PRS.0b013e3181fad34d.  PubMed  PMID
9 Spear SL, Rottman SJ, Glicksman C, Brown M, Al-Attar A. Late seromas after breast implants: theory and practice. Plast Reconstr Surg. 2012 Aug;130(2):423-35
10 Adams, WP. Discussion: Anaplastic Large Cell Lymphoma Occurring in Women with Breast Implants: Analysis of 173 Cases. Plastic & Reconstructive Surgery: March 2015 – Volume 135
11 Gidengil CA, Predmore Z, Mattke S, van Busum K, Kim B. Breast implant-associated anaplastic large cell lymphoma: a systematic review. Plast Reconstr Surg. 2015 Mar;135(3):713-20.
12 Hu H, Jacombs A, Vickery K, Merten SL, Pennington DG, Deva AK. Chronic biofilm infection in breast implants is associated with an increased T-cell lymphocytic infiltrate implications for breast implant-associated lymphoma. Plast Reconstr Surg. 2015 Feb;135(2):319-29
13 Anderson A, Bakhed F, Euler A, Richter-Dahlfors A, Sutherland D, Kasemo B. Nanoscale features influence cell morphology and cytokine production. Biomaterials 2003 (24): 3427-3436
14 Nava MB, Rancati A, Angrigiani C, Catanuto G, Rocco N. How to prevent complications in breast augmentation. Gland Surgery. 2017;6(2):210-217. doi:10.21037/gs.2017.04.02