The Plastic Surgery Foundation
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Grants We Funded

Grant applicants for the 2023 cycle requested a total of nearly $4 million dollars. The PSF Study Section Subcommittees of Basic & Translational Research and Clinical Research evaluated nearly 140 grant applications on the following topics:

The PSF awarded research grants totaling over $1 million dollars to support nearly 30 plastic surgery research proposals.

ASPS/PSF leadership is committed to continuing to provide high levels of investigator-initiated research support to ensure that plastic surgeons have the needed research resources to be pioneers and innovators in advancing the practice of medicine.

Research Abstracts

Search The PSF database to have easy access to full-text grant abstracts from past PSF-funded research projects 2003 to present. All abstracts are the work of the Principal Investigators and were retrieved from their PSF grant applications. Several different filters may be applied to locate abstracts specific to a particular focus area or PSF funding mechanism.

Blood Siloxanes and Urinary Methylsilanols to Detect Ruptured Silicone Implants

Principal Investigator
Michael Delong MD

Year
2017

Institution
The Regents of the University of California, Los Angeles

Funding Mechanism
National Endowment for Plastic Surgery Grant

Focus Area
Breast (Cosmetic / Reconstructive), Technology Based

Abstract
Silicone breast implants, composed of a sturdy silicone shell filled with a malleable silicone gel elastomer, have been used for decades for reconstruction after mastectomy and for cosmetic augmentation. Silicone is currently regarded as safe but implant rupture is considered an indication for explantation as the leaked silicone is known to induce an inflammatory response with unknown consequences. Current guidelines by the Food and Drug Administration (FDA) recommend periodic Magnetic Resonance Imaging (MRI) studies at three years following implantation, and then every two years thereafter to detect potential implant rupture. However, MRI is both expensive and time consuming and compliance with these recommendations is low.
While silicone implants are primarily filled with high molecular weight siloxane polymers, it has been revealed that short chain cyclic volatile methylsiloxanes (cVMS) comprise 1-2% of implant contents. These cVMS's are capable of permeating through patient tissues, and have been detected in the blood of patients with silicone implants, even years after explantation. Further, recent studies have demonstrated a trend towards higher cVMS blood concentrations in patients with ruptured silicone implants, although study size was inadequate to obtain statistically significant results. We believe that an appropriately powered study would confirm that cVMS blood concentrations reliably increase with silicone implant rupture.
Additionally, high molecular weight silicone gel siloxane elastomers can undergo hydrolysis to end products including dimethylsilanediol (DMSD) and trimethylsilanol (TMS), which are excreted in the urine. Although elemental silicon and silica are regularly consumed in the normal human diet, these consumed compounds are typically metabolized into orthosilicic acid in the intestines, with the majority excreted in feces. No study to date has attempted to detect an increase in urine DMSD and/or TMS in patients with ruptured silicone breast implants. We propose to additionally determine whether a significant increase in urine metabolic byproducts can be detected in patients with ruptured silicone breast implants as compared to control patients without implants, and control patients with intact silicone implants.
Either of these findings would allow the development of an inexpensive screening method for silicone implant rupture, with MRI reserved for confirmation in positive patients.

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.