Synthetic Implants And Their Potential Complications In Plastic Surgery
Next to orthopedic surgery, plastic surgery as a medical specialty uses a significant number of implants and implant materials to help achieve its surgical outcomes. Whether it is breast implants or an injectable filler, the use of synthetic or foreign materials is common in plastic surgery. Often when a plastic surgery patient needs an implant for their procedure, they will ask the question....'What if my body rejects the implant?'. This understandable concern is indicative of a basic misunderstanding of how the body reacts to implanted foreign materials and what type of complications can develop.
In reality, the rejection of an implanted synthetic material (that has been evaluated and approved for human implantation by the FDA), in the most scientific sense, does not happen. A true rejection reaction in humans is an autoimmune response to an 'implant' that is composed of live or organic material. Therefore, you will develop a rejection or autoimmune reaction, for example, in any type of organ transplant which is from other human or animal origins. Your body's cells mount a massive response to what it recognizes as foreign or an invading organic source. The body is quite smart and protective as this type of response is necessary for survival.
Synthetic implants are composed of inorganic materials, which do not cause a true allergic or autoimmune response. These are not live materials and were never composed of living organic materials. Therefore, an allergic response does not happen. They will never integrate or become part of your body's tissues, but they can be tolerated by occupying a walled-off space. Synthetic implants, while not causing allergic responses, can cause a different set of problems which patients mistakenly interpret as 'rejection'. Synthetic implants can get infected, exposed, or migrate, all of which are complications of the surgical implantation process not due to rejection. If bacteria inadvertently get on the surface of the implant, an infection can later develop.Most implant infections occur within weeks of the surgery as it takes time for the bacteria to multiply and become evident. Synthetic implant migration occurs particularly in smooth implants which can easily slide away from its intended position if they are not secured into position or the pocket into which it is placed is too big. This potential migration can be eliminated if the implant is secured into its desired location by some method such as sutures or metal screws. Implant exposure can result from migration of the implant, getting close to the original incision through which it is placed. Or implant exposure can result from not having enough good tissue closed over it or tissue that breaks down over the implant due to too much pressure that the implant exerted on it or the overlying tissue is of poor quality and it doesn't heal well and then breaks down, thus exposing the implant.
The typical synthetic implant complications are often misinterpreted as rejection of the implant. In reality, the patient's body has little to do with the development of these complications. They are more a function of surgical technique and not due to a patient's immune response to them. The risk of these potential implant complications can be reduced by pre-surgery antibiotics, a properly sized implant that does not stress the surrounding tissues, and careful surgical implantation technique.
Dr Barry Eppley, board-certified plastic surgeon of Indianapolis, is in private practice at Clarian Health in Indianapolis. He writes a daily blog on topics and trends in plastic surgery at www.exploreplasticsurgery.com
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