Early Tissue Reaction to Textured Breast Implant Surfaces

Brohim, Robert M.; Foresman, Pamela A.; Hildebrandt, Paul K.; Rodeheaver, George T.

doi:10.1097/00000637-199204000-00010

Cited by 90 publications

(64 citation statements)

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“…This study suggests the hypothesis that there might be less contraction in the textured prostheses due to the decrease of adhesive capsular characteristic, thus decreasing the mechanical friction previously mentioned 9,14 . The necessary force to loosen the membrane´s periimplant tissue indirectly demonstrated the invasion of this tissue inside the coating's texture.…”

Section: Discussionsupporting

confidence: 59%

“…There are collateral effects associated with implants because they stimulate the defense mechanism to eliminate it as a foreign body. Among the materials used in implants, silicone is one of the most inactive materials, due partly to its hydrophobic characteristic that impedes chemical and enzymatic agents to affect the material Many studies attested to the superiority of textured membranes over the smooth ones in capsular reduction 13,14 . This textured quality is directly related to the degree of discontinuity of the capsule and the consequent reduction of its contracture.…”

Section: Discussionmentioning

confidence: 99%

“…Brohim 14 used fragments of the surface of prostheses in order to obtain microscopic data on peri-implant reaction to different coating textures. Following the same procedure, the authors of this study used coating fragments of silicone prostheses.…”

Section: Discussionmentioning

confidence: 99%

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Healing reaction to mammary prostheses covered by textured silicone and silicone foam in rats

et al. 2009

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Purpose:To compare the capsular reaction to two different coverings of silicone prosthesis through the biophysical characteristic of adherence and microscopical aspects of the inflammatory reaction and collagen formation. Methods: Thirty two Wistar rats were used. In the dorsum of each animal a silicone elastomer with a smooth superficies and another coated with texturized silicone (Mentor) was implanted. Another one, with the same smooth superficies and other coated with silicone foam (Lifesil), making up in each side, of the dorsum, the texturized and silicone foam group respectively. The animals were split into four groups to be evaluated at 7, 14, 30 and 60 days. On the evaluation dates the implant adherence was verified witch a tensiometer and the values in kgf were obtained. The material was sent to histological analysis with hematoxilin-eosin and picrosirius colorations, to evaluate the inflammatory reaction and collagen synthesis, respectively. The obtained data were submitted to statistical treatment. Results: There was more adherence of the tissue to the silicone foam (P<0,001). The inflammatory reaction was more intense in the same group, but without statistical significance. The number of giant cells and granulomas were more frequent in the silicone foam group. There was statistical significance at the 60 days for granulomas (P<0,028) and for all subgroups about number of giant cells (P< 0,012 to P<0,036). The thickness of the capsule in the silicone foam group was bigger, with statistical significance at seven days (P<0,028) and 60 days (P<0,012). The collagen deposition showed no difference in statistical analysis. Conclusion: The capsular reaction to the silicone foam showed stronger adherence, bigger thickness and had more number of granulomas and giant cells. No difference was observed in the intensity of inflammatory reaction in relation to type I and III collagen, when compared to the texturized cover. Key words: Breast Implantation. Silicones. Biocompatible Materials. Contracture. Rats. RESUMO Objetivo:Comparar a reação capsular de dois revestimentos de próteses de silicone através da característica biofísica de aderência e dos aspectos microscópicos de reação inflamatória e formação de colágeno. Métodos: Implantaram-se no dorso de 32 ratos duas membranas de silicone ambas possuindo uma superfície lisa e outra diferindo em sua estrutura. Estes revestimentos foram de espuma de silicone (LifeSil) ou silicone texturizado (Mentor). Os dois grupos foram divididos em quatro sub-grupos conforme o tempo de pós-operatório avaliado: 7, 14, 30 e 60 dias. Obteve-se material para análise biofísica de aderência, a qual foi realizada com tensiômetro para obtenção de valores em kgf. O estudo microscópico da reação inflamatória e síntese de colágeno foi realizado com colorações de hematoxilina-eosina e picrosirius. Os dados foram submetidos a testes para avaliação da significância estatística. Resultados: Houve maior aderência do revestimento de espuma de silicone ao tecido capsular, sendo este valor...

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

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Healing reaction to mammary prostheses covered by textured silicone and silicone foam in rats

et al. 2009

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“…Surface characteristics have undergone changes and evolved with all three manufacturers working towards the common goal of utilizing texture to possibly minimize or even disrupt capsule formation (29,30). The evolution of textured implants began with polyurethane-coated implants reporting lower capsular contracture rates (31).…”

Section: Surfacementioning

confidence: 99%

Breast implant design

Maxwell¹,

Gabriel²

2017

Gland Surg.

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“…Some researchers further suggested that TGF-~l has diverse effects that include modulating cell proliferation, survival and apoptosis; enhancing extracellular matrix production and adhesion (14). The presence of myofibroblasts in the contracted capsule is reported to be related to a-smooth muscle actin (a-SMA) production, with more severely deformed capsules displaying a higher a-SMA production, which points to a direct role of activated myofibroblasts in the development of contracture (13). It has also been demonstrated that the number ofmyofibroblasts present in the tissue is proportional to the thickness of the contracture (9).…”

mentioning

confidence: 99%

Effects and Zafirlukast on Capsular Contracture: Long-Term Results

Mazzocchi

Dessy

Alfano

et al. 2012

Int J Immunopathol Pharmacol

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Capsular contracture is a distressing complication after breast augmentation for both the patient and surgeon. Although capsular contracture is a multifactorial process, one common denominator in the successful treatment of this complication is believed to be the abatement of inflammation. Leukotriene antagonists have recently emerged as effective prophylactic agents in reactive airway diseases. A prospective study was carried out on 60 female patients (120 prostheses implanted) with mild/severe capsular contracture in at least one breast. The hardness of capsular contracture was assessed by means of the mammary compliance method. Patients received zafirlukast (AccolateTM) for a 6-month period. Mammary compliance was assessed at the start of the study and thereafter monthly, during drug intake and for one year after drug withdrawal. The results show a significant decrease in breast compliance values in the first 6 months, followed by a significant increase one year after the end of drug intake. Indeed, zafirlukast-treated patients displayed a 6.93% reduction in mammary compliance after 1 month, 14.42% after 3 months, 22.05% after 6 months and 22.52% after 7 months (1 month after the withdrawal of the drug). Thereafter, mammary compliance values gradually increased. A 5.47% reduction in mammary compliance was observed 1 year after drug withdrawal. The present study suggests that zafirlukast may be effective in reducing breast capsule distortion in patients with long-standing contracture, though reduced capsular contracture values are strictly related to the duration of drug intake. Capsular contracture is the most common problem and cause of patient dissatisfaction following augmentation mammaplasty and mammary reconstruction with breast implants; the reported rates of this complication range from 0.5 to 59% (1).Every patient who undergoes implantation with an alloplastic implant experiences capsules around the prostheses. Fibrotic tissue promotes compression around the implant, which in tum distorts and deforms the mass, compromising the aesthetic result and causing pain (2-7). Breast firmness that is so marked as to result in a painful, hard breast, on occasion with visible distortion, has been termed fibrous capsular contracture (8). A number of intraoperative and postoperative factors may be linked to capsular contracture. Unfortunately, as few strictly-controlled studies have been conducted to investigate the causes and possible prevention of capsular contracture, there are as yet no definite data on the aetiopathogenesis of this complication (8). Although the pathogenesis of capsular contractere is still unclear, most reports indicate a multifactor explanation (2-6).The development of a fibrotic capsule around

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Early Tissue Reaction to Textured Breast Implant Surfaces

Cited by 90 publications

References 0 publications

Healing reaction to mammary prostheses covered by textured silicone and silicone foam in rats

Healing reaction to mammary prostheses covered by textured silicone and silicone foam in rats

Breast implant design

Effects and Zafirlukast on Capsular Contracture: Long-Term Results

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