Omega-3 supplementation may prevent capsular contracture: Study

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Scientists in Italy surgically inserted miniature implants in mice to determine whether fish oil is effective in reducing the occurrence of a common breast implant complication.

One of the most common complications among women who undergo breast implant surgery is capsular contracture said a new study.

Capsular contracture is when a "capsule" of scar tissue forms around medical or cosmetic implants. Scarring is a normal part of the healing process, however, in some patients, the scar tissue becomes unusually hard and will contract around the implant. The complication can lead to pain and discomfort, and in extreme cases requires further surgery. 

According to plasticsurgery.org, about one in six breast augmentation patients experience some degree of capsular contracture. 

Previous research on capsular contracture has focused largely on reducing bacterial contamination through antibiotic solutions. Less attention has been paid to the inflammation process, with particular focus on the main inflammation pathway, the arachidonic acid cascade. These pathways are impacted by the omega-3 fatty acids, found mostly in oily fish and dietary supplements. 

To gain a better understanding of the effects of omega-3 supplements on capsule contraction, Italian researchers conducted an experimental study to see if omega-3 fatty acid supplementation affects capsule formation around implants in animals. The research is published in the March issue of Plastic and Reconstructive Surgery.

The study

At 8 weeks of age, a group of 32 mice underwent plastic surgery. The mice were implanted with tiny, custom-made 300-mg silicone gel implants. Following their operations, the mice were divided into two groups of 16. 

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Custom-made, 300-mg, round smooth silicone gel implants (Mentor Corp.)

The treatment group received omega-3 oil daily supplementation and the control group received water.

After 12 weeks, the mice were euthanized and the implants removed. The implants and surrounding fibrous tissue were harvested in one piece and capsule thickness around the implants were compared between the two groups.

Results 

The results found reduced capsule formation in the treatment group, with the implants thinner and more transparent than in the comparison group.

“The average capsular thickness was 205.09 μm in the omega-3 group, compared with 361.63 μm in the control group. This difference was statistically significant (p = 0.0004),” the report pointed out. 

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Implants with the surrounding fibrous tissue (capsule) were harvested in one piece.

In addition, capsules from the omega-3-supplemented mice exhibited reduced expression of transforming growth factor (TGF) beta-2: a cell-activating protein (cytokine) that promotes inflammation. The reduced capsule formation around implants was likely due to reduced collagen deposits, said the authors. 

Conclusion

The authors acknowledge further clinical studies are warranted and point out that humans taking the amount of omega-3 supplementation similar to that given to the mice in the study "would be quite a dose.”

However, the results are promising for those seeking medical or cosmetic implants. The authors said given the minimal side effects associated with omega-3 fatty supplements, We believe that omega-3 supplementation is a simple and promising method that could be used to prevent or at least reduce capsular contracture after silicone implant surgery. This therapy could have a significant impact considering the number of patients every year who undergo breast reconstruction or aesthetic mammaplasty.” 

Source: Plastic and Reconstructive Surgery

March 2020 - Volume 145 - Issue 3 - p 701-710 doi: 10.1097/PRS.0000000000006553

“The Effect of Omega-3 Fatty Acids on Capsular Tissue around the Breast Implants, Plastic and Reconstructive Surgery”

Authors: G. Lombardo et al.