**1. Introduction**

Silicone rubber (SR) is a type of biomaterial that exhibits many useful properties, such as thermal stability, chemical resistance, and low cost [1]. It has a long history of use in biomedical

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and biological applications, ranging from tissue fillers to tubes for dialysis and blood pumps [2–4]. Silicone rubber and silicone rubber-based materials have been used as medical tissue implants in the field of plastic surgery for many years, but there remain reports of adverse reactions to long-term implants, such as capsular contracture [5, 6]. Moreover, various prosthetic materials that contain silicone rubber can easily move and can permanently damage the prostheses. In addition, certain materials made from silicone rubber, such as catheters, are widely used in medicine but have several limitations; for example, bacteria can readily colonize the surfaces of silicone rubber, facilitating infection and even causing patient death in certain cases [5, 7–9].

In recent years, many attempts have been made to modify medical materials to reduce bacterial adhesion and to minimize adverse inflammatory or foreign body reactions [10–15]. Among these methods, the surface modification of biomaterials is an economical and effective method to achieve biocompatibility and biofunctionality while preserving the favorable characteristics of the biomaterial, such as particular mechanical properties and thermal stability. Surface modifications, such as ion implantation [16–18], sintering [19], electrochemical deposition [20], and the sol-gel coating method, are common [21]. Among these surface modification methods, ion implantation has become a notably useful method because of its ease of operation and convenience [22–25]. In this context, we implanted three different doses of carbon ions into silicone rubber and obtained carbon ion silicone rubber (C-SR). Our study was designed to evaluate the surface characteristics and the biocompatibility of carbon ion silicone rubber. We focused on bacterial adhesion, cytocompatibility, and fibrosis/fibrous capsule development. The long-term goal is to gain a better biomaterial for use by plastic surgeons.
