Altered systemic serologic parameters in patients with silicone mammary implants

Wolfram, Dolores; Oberreiter, B.; Mayerl, Christina; Soelder, Elisabeth; Ulmer, Hanno; Piza‐Katzer, Hildegunde; Wick, Georg; Backović, Aleksandar

doi:10.1016/j.imlet.2008.03.007

Cited by 33 publications

(22 citation statements)

References 30 publications

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“…This is not the only molecule that has been discussed as a potential biomarker. Wolfram et al [ 32 ] also found that, in those with silicone breast implants, circulating immune complexes, antipolymer antibodies and soluble intercellular adhesion molecule-1 were also upregulated, and their levels correlated with the development of fibrosis.…”

Section: Pathogenesis Of Capsular Contracturementioning

confidence: 99%

Capsular Contracture after Breast Augmentation: An Update for Clinical Practice

2015

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Capsular contracture is the most common complication following implant based breast surgery and is one of the most common reasons for reoperation. Therefore, it is important to try and understand why this happens, and what can be done to reduce its incidence. A literature search using the MEDLINE database was conducted including search terms 'capsular contracture breast augmentation', 'capsular contracture pathogenesis', 'capsular contracture incidence', and 'capsular contracture management', which yielded 82 results which met inclusion criteria. Capsular contracture is caused by an excessive fibrotic reaction to a foreign body (the implant) and has an overall incidence of 10.6%. Risk factors that were identified included the use of smooth (vs. textured) implants, a subglandular (vs. submuscular) placement, use of a silicone (vs. saline) filled implant and previous radiotherapy to the breast. The standard management of capsular contracture is surgical via a capsulectomy or capsulotomy. Medical treatment using the off-label leukotriene receptor antagonist Zafirlukast has been reported to reduce severity and help prevent capsular contracture from forming, as has the use of acellular dermal matrices, botox and neopocket formation. However, nearly all therapeutic approaches are associated with a significant rate of recurrence. Capsular contracture is a multifactorial fibrotic process the precise cause of which is still unknown. The incidence of contracture developing is lower with the use of textured implants, submuscular placement and the use of polyurethane coated implants. Symptomatic capsular contracture is usually managed surgically, however recent research has focussed on preventing capsular contracture from occurring, or treating it with autologous fat transfer.

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Section: Pathogenesis Of Capsular Contracturementioning

confidence: 99%

Capsular Contracture after Breast Augmentation: An Update for Clinical Practice

2015

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“…These histological findings, which were classified by the Wilflingseder score,35 correlated well with the clinical Baker classification (Table 1, Figure 1). In addition, it could be demonstrated that serum hyaluronan levels,29 as well as circulating immune complexes, procollagen III, antipolymer antibodies, and soluble intercellular adhesion molecule 1 (sICAM-1),36 were significantly elevated in patients with CC, also correlating in part with the clinical Baker stage of contracture 29. After multiple experimental and clinical trials, there seems to be a strong consensus that the use of textured outer shell surfaces, in comparison with smooth surfaces, is able to decrease the incidence of CC by disrupting contractile forces around the implant,28,37–42 emphasizing the need for better physical properties than cellular or pharmacological strategies of contracture formation.…”

Section: Capsular Contracturementioning

confidence: 99%

Capsular contracture by silicone breast implants: possible causes, biocompatibility, and prophylactic strategies

Steiert¹,

Boyce²,

Sorg³

2013

MDER

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The most common implanted material in the human body consists of silicone. Breast augmentation and breast reconstruction using silicone-based implants are procedures frequently performed by reconstructive and aesthetic surgeons. A main complication of this procedure continues to be the development of capsular contracture (CC), displaying the result of a fibrotic foreign body reaction after the implantation of silicone. For many years, experimental and clinical trials have attempted to analyze the problem of its etiology, treatment, and prophylaxis. Different theories of CC formation are known; however, the reason why different individuals develop CC in days or a month, or only after years, is unknown. Therefore, we hypothesize that CC formation, might primarily be induced by immunological mechanisms along with other reasons. This article attempts to review CC formation, with special attention paid to immunological and inflammatory reasons, as well as actual prophylactic strategies. In this context, the word “biocompatibility” has been frequently used to describe the overall biological innocuousness of silicone in the respective studies, although without clear-cut definitions of this important feature. We have therefore developed a new five-point scale with distinct key points of biocompatibility. Hence, this article might provide the basis for ongoing discussion in this field to reduce single-publication definitions as well as increase the understanding of biocompatibility.

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“…36 The tissue response to a biocompatible material follows a well-defined course of events following the injury itself. 38 Histological studies by Wolfram et al on explanted breast implants found a strong presence of CD4þ cells, macrophages, as well Langerhans-cell-like dendritic cells (DCs). The extent of this response depends on various material characteristics as well as the presence of various cytokines, growth factors and proteins.…”

Section: Discussionmentioning

confidence: 99%

“…37 Variable numbers of inflammatory cells have been noted in the peri-implant fibrous tissue around silicone implants. 38 Histological studies by Wolfram et al on explanted breast implants found a strong presence of CD4þ cells, macrophages, as well Langerhans-cell-like dendritic cells (DCs). 39 The development of a fibrous barrier between ORIGINAL ARTICLE JOURNAL OF BIOMEDICAL MATERIALS RESEARCH A | MAY 2012 VOL 100A, ISSUE 5 the foreign material and the surrounding tissue is the morphological consequence of insufficient biocompatibility.…”

Section: Discussionmentioning

confidence: 99%

Covalent vectored binding of functional proteins by bifunctional crosslinking at silicone interfaces

Steiert

Reimers

Burke

et al. 2012

J Biomedical Materials Res

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In the daily clinical routine, numerous synthetic medical devices are implanted in the human body, either temporarily or permanently. The synthetic material most often implanted is polydimethylsiloxane (silicone). Numerous studies have demonstrated that silicone is encompassed in a connective tissue capsule by the body, preventing integration into the surrounding tissue. This can result in complications. The aim of our study was to develop a simple procedure to functionalize the silicone surface, thereby positively affecting the material's biocompatibility. By combining a silanization with the use of ester activation, a reactive amino group is generated, which can bind any free carboxyl group. Directional crosslinking of a near-infrared-conjugated fluorophore antibody to the activated silicone surface could be demonstrated on a dose-dependent basis. The redox reaction at a silicone surface coated with an HRP-conjugated antibody caused by the addition of NBT/BCIP could be shown. Covering the silicone discs with an anti-FAS-antibody coating followed by a coincubation with FAS-sensitive T-cells allowed highly significant detection of caspase-3. In summary, our crosslinking procedure enables the stable binding of proteins without the loss of biological function. Through this process, silicones could be endowed with new functions which could improve their biocompatibility.

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Altered systemic serologic parameters in patients with silicone mammary implants

Cited by 33 publications

References 30 publications

Capsular Contracture after Breast Augmentation: An Update for Clinical Practice

Capsular Contracture after Breast Augmentation: An Update for Clinical Practice

Capsular contracture by silicone breast implants: possible causes, biocompatibility, and prophylactic strategies

Covalent vectored binding of functional proteins by bifunctional crosslinking at silicone interfaces

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