Joshua Vorstenbosch, MD PhD FRCSC

Summary of Research:

Implantable devices are used across the breadth of plastic surgery. Following surgical placement of an implant, the body evokes a foreign body reaction at the interface of the device. Of particular interest to plastic surgeons, deregulated foreign body reactions at the interface of breast implants lead to symptomatic capsular contracture and sustained inflammation that is thought to contribute to the pathogenesis of breast implant associated anaplastic large cell lymphoma (ALCL).

In implant-based breast cancer reconstruction, depending on the inflammatory microenvironment and tissue type adjacent to the implant the capsule may remain benign, undergo fibrosis, or in some cases, metaplasia to ALCL. While both bacteria and growth factors such as transforming growth factor-beta (TGF-beta) have been shown to be critically involved, the exact timing and mechanisms by which they exert their effects in capsular contracture and ALCL remain obscure. Based on a limited sample size, STAT3 appears to be involved in ALCL but the temporal changes occurring in the capsule leading up to that point have not been investigated.

The goals of my research program are: (1) to identify temporal changes in the inflammatory molecular and cellular microenvironment leading to breast implant associated ALCL, (2) to characterize distinct molecular pathways underlying the inflammatory and fibrotic responses to implantable devices in breast reconstruction patients, and (3) to determine the roles of specific cell/tissue types adjacent to the breast implant in inducing capsular contracture in breast cancer reconstruction.

      Joshua Vorstenbosch

       

      Position:

      Assistant Professor of Surgery, McGill University

      Area of Research:

      Plastic Surgery

      Contact:

      joshua.vorstenbosch [at] mcgill.ca

       

      Clinical Interests:

      • Breast reconstruction
      • Reconstruction of complex oncologic defects
      • Abdominal wall reconstruction
      • Chest wall reconstruction

       

      Research Interests:

      • Breast Implant Associated Anaplastic Large Cell Lymphoma
      • Breast implant safety
      • Breast implant capsular pathology
      • Tissue-implant interactions
      • Inflammation as a driver of fibrosis and oncogenesis
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