Electron and Light Microscopy Examination of Capsules Around Breast Implants

Follistatin and the Breast Implant Capsule

“…In this day 28 group, an increase in serum IL-6 suggested the presence of a subclinical systemic inflammatory response although there were no obvious signs of infection or surgical complications. These data highlight the complexity of capsule formation and fibrosis 7–15 and suggest that other factors such as subclinical infection that were not assessed in our study may be involved in the process. 32–34 …”

Influence of Silicone Sheets on Microvascular Anastomosis

“…With in vivo silicone implantation, postoperative formation of a fibrous connective tissue capsule around the silicone implant is inevitable [3,13,30,32]. Essentially, the formation of this capsule is one of the body's defense mechanisms to completely isolate foreign bodies [7,9,[30][31][32]. Vistnes et al [30] reported that in the acute stage of the initial inflammatory response, if phagocytes failed to remove large implants as a silicone sheet, collagenous fibers would infiltrate and be arranged directly around the implant to form a fibrous tissue capsule isolating the foreign body.…”

“…During the entire chronic stage, acid mucopolysaccharides were associated predominantly with the collagenous fibers. The foreign body reaction process that produces the fibrous capsule continues as long as the implant is present but disappears when the silicone sheet is completely removed [30][31][32]. Formation and development of this fibrous capsule are influenced by several factors such as properties of the silicone implant [7,30], local surgical trauma [9,14,30], postoperative formation of seroma or hematoma [30], and bleeding from local small vessels [29][30][31].…”

“…Silicone implants are widely used for breast augmentation [3,7,9,29,31], restoration of contour deficiencies [18], scar management [20], and intensifying neovascularization in prefabricated flaps [15,21,28]. They also have been used experimentally and clinically in association with free vascularized flaps to reconstruct tissue defects in the ear and nose [4,12,16], and the trachea [6].…”

Silsesquioxane Nanocomposites as Tissue Implants

“…9 Nevertheless, polyurethane implants have not gained much popularity because of the carcinogenic risks of toluene diamine, a degenerative byproduct of polyurethane 10 ; the difficulty associated in removing textured prostheses 11 ; and significant foreign body reaction. 12 All this has caused some degree of confusion, with different implants being used in different parts of the world. 13 Although it is true that silicone is relatively inert, its tendency to fragment into miniscule particles 14 limits its interfacial biocompatibility, and this holds true for polyurethanes as well.…”