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Bacterial biofilms present on explanted facial implants

A majority of removed facial implants had some degree of biofilm formation, with porous polyethylene implants having more severe biofilm formation, according to study results published in JAMA Facial Plastic Surgery.

Researchers analyzed facial implants explanted by a single surgeon from seven patients with previously placed alloplastic facial implants who underwent revision rhinoplasty and removal of facial implants between July 1, 2012, and June 30, 2013. The analysis included four silicone and three porous polyethylene implants.

There were six nasal dorsal implants and one midface cheek implant. Silicone and porous polyethylene implants that had not been implanted were used as controls. The implants were removed due to suspected infection or during revision surgery for other indications.

Biofilm formation to various degrees was shown on all porous polyethylene implants

“One of the three porous polyethylene implants demonstrated severe biofilm formation on the entire implants, and the other two porous polyethylene implants showed areas of mild and severe biofilm formation,” the researchers wrote.

Two of the four silicone implants had no evidence of biofilm. One silicone implant had no biofilm formation in one area and severe biofilm in another location. Moderate and severe biofilm formation was observed on the other silicone implant.

“This qualitative study illustrates that bacterial biofilms are present on explanted alloplastic facial implants,” the researchers concluded. “Furthermore, the results … suggest that alloplastic implants with rougher surfaces, such as porous polyethylene, form biofilms more readily and more densely than smother implants, such as silicone. Scanning electron microscopy is an excellent tool to identify areas of biofilm formation.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.