No … Unfortunately I cannot report a big breakthrough in this difficult problem, but I can report that we are making progress in understanding the mechanism.
I just returned from a Scientific Summit hosted by Mentor, which is the main breast implant manufacturer in my opinion. The subject of capsular contracture was discussed in detail, and the foremost scientific mind in the world was there.
He is a scientist who has studied this problem more than anyone else in the world. He presented some fascinating findings.
First, he described a biofilm, which is a term to mean an attachment of one or more colonies of bacteria on a surface. Surprisingly bacteria have a social life and communicate via quorum sensing chemicals. When they settle on a surface of anything they are very hard to eradicate.
They might settle on the surface of a breast implant or the scar capsule.
There are probably multiple causes of capsular contracture and biofilm is probably one of them. The research is exciting. It is promising, but it is frustratingly slow.
Bacteria have two states. One is the planktonic state where they float around in fluids or even gases. The other state is when they attach themselves to a surface. When we take a culture, we are sampling the planktonic state usually. When they attach themselves to a surface they are attached stronger than superglue, and they cannot be dislodged with a culture stick.
They pile up on top of each other in the biofilm and if we add antibiotics the antibiotic cannot penetrate. The outer surface bacteria might be killed off, but the deeper ones survive and multiply.
The biofilm is well organized with the same type of bacteria living together and with spaces within the colonies for fluid to flow. The body fluid contains protein, which is their nutrient and keeps them alive.
More later …