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Their biomaterial surface components in contact with tissues are, however, susceptible to the host's foreign body response, which drives inflammation and implant fibrous encapsulation. When dysregulated, this response causes implant\u2010related patient morbidity and device failure, ultimately requiring revision surgery. Here, we review the roles that the biomaterial, the host, and the implantation surgery play in the foreign body response. Taking commonly\u2010used implantable medical devices as examples, we first describe the foreign body response; then, we examine the factors influencing it, and finally, we propose ideas of how it can be controlled perioperatively in an attempt to minimize implant\u2010related complications.<\/jats:p>","DOI":"10.1002\/jbm.a.37983","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T11:21:41Z","timestamp":1756898501000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Implantable Medical Devices, Biomaterials, and the Foreign Body Response: A Surgical Perspective"],"prefix":"10.1002","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9944-9542","authenticated-orcid":false,"given":"Nikita","family":"Kalashnikov","sequence":"first","affiliation":[{"name":"Division of Surgical and Interventional Sciences, Department of Surgery McGill University  Montreal Canada"},{"name":"Research Institute of the McGill University Health Centre  Montreal Canada"},{"name":"Faculty of Medicine and Health Sciences McGill University  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3543-6042","authenticated-orcid":false,"given":"Jake","family":"Barralet","sequence":"additional","affiliation":[{"name":"Division of Surgical and Interventional Sciences, Department of Surgery McGill University  Montreal Canada"},{"name":"Faculty of Dental Medicine and Oral Health Sciences McGill University  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8548-6625","authenticated-orcid":false,"given":"Joshua","family":"Vorstenbosch","sequence":"additional","affiliation":[{"name":"Division of Surgical and Interventional Sciences, Department of Surgery McGill University  Montreal Canada"},{"name":"Research Institute of the McGill University Health Centre  Montreal Canada"},{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery McGill University Health Centre  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/adfm.202007226"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smim.2007.11.004"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/bios10070079"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/bioengineering8120205"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.a.36930"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2006.07.007"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nmat2441"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41578-020-0209-x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/natrevmats.2016.40"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41578-018-0023-x"},{"issue":"1","key":"e_1_2_10_12_1","first-page":"1","article-title":"Bioactive Potential of Natural Biomaterials: Identification, Retention and Assessment of Biological Properties","volume":"6","author":"Joyce K.","year":"2021","journal-title":"Signal Transduction and Targeted Therapy"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41578-019-0150-z"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-immunol-030409-101311"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri2873"},{"issue":"2","key":"e_1_2_10_16_1","first-page":"52","article-title":"Surgical Physiology of Wound Healing: A Review","volume":"43","author":"Deodhar A. 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