Grants We Funded

Abstract
Capsular contracture remains a significant complication of breast augmentation. Prior investigation has hypothesized that subclinical bacterial infection and biofilm formation, particularly from coagulase-negative staphylococcus species, play a causative role in the development of capsular contracture. However, all prior research has isolated causative organisms via cell culture alone. Advances in microbiology have developed genotype sequencing technologies for detecting subclinical bacterial concentrations. By using this more sophisticated approach, we propose to confirm the subclinical infection hypothesis while simultaneously obtaining further detail regarding the specific isolated organisms, as well as their prevalence, concentration, and genetic composition. This study will provide useful information regarding the etiology of capsular contracture, and may eventually aid the development of preventative measures or novel therapies. Additionally, the comparison of genotyping and culture detection methods could help determine the marginal benefit of the more expensive genotyping method.
We propose to obtain samples of the tissue capsule surrounding breast implants during explantations. We will obtain samples from patients cohorts with severe capsular contracture, graded Baker classification III or IV, and cohorts with Baker I. These samples will then be processed to identify subclinical infectious bacterial colonies by cell culture and by genotype analysis. We will compare the patients with no capsular contracture to those with severe capsular contracture to confirm whether there is a correlation with subclinical infection. We will then determine whether genotype analysis similarly replicates or enhances these findings, and will further investigate whether bacterial genotype differences exist between the two patient cohorts.

Biography
As a plastic and reconstructive surgery resident physician at the University of California at Los Angeles, I am interested in general clinical plastic surgery spanning both reconstructive and cosmetic procedures. My research interests include translational medicine and the development of new technologies. In medical school I spent a dedicated year investigating innovative bispecific antibody therapies for glioblastomas. I was also the lead author on a manuscript characterizing the use of a novel sternal closure device. In addition, I have published on academic careers in plastic surgery, maintain a strong commitment to academic medicine, and am planning to take two dedicated research years during my residency. Recently, I have developed a specific interest in breast implants. I currently serve as the principal investigator on an active grant using a highly sensitive genotyping detection method to better understand the subclinical infection hypothesis for capsular contracture. I ultimately hope to contribute to the development of novel technologies, specifically for improving breast implant devices with the goal of reducing complications, morbidity, reoperation rates, and costs associated with their use.