Histology of the capsules causing constrictive fibrosis around breast implants

Sˇmahel, Jirˇi

doi:10.1016/0007-1226(77)90132-1

Cited by 57 publications

(18 citation statements)

References 4 publications

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“…Also as noted above, in vitro studies have shown that IFN-'y down-regulates collagen and fibronectin synthesis (16)(17)(18) and this decreased synthesis is associated with decreased levels of mRNA (19)(20)(21). Fibrous capsule formation around alloplastic implants in humans and animals, including breast implants (38,39), silicone plates (40), Marlex mesh (41), and nylon velour pouches (42) has been observed previously. Our finding that a similar phenomenon occurs with the osmotic pumps allowed us to develop an in vivo model for soluble mediator effects on new collagen synthesis.…”

Section: Discussionmentioning

confidence: 67%

Gamma-interferon inhibits collagen synthesis in vivo in the mouse.

Granstein¹,

Murphy²,

Margolis³

et al. 1987

J. Clin. Invest.

166

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Subcutaneous implantation of osmotic pumps into CAF1 mice resulted in the formation of thick fibrous capsules around the pumps. When pumps were loaded with recombinant murine gamma-interferon (rMuIFN-'y) to deliver 2 X 103 U/h for 14 d, there was a marked decrease in thickness and collagen content of the capsules from rMuIFN-'y-treated animals compared with capsules from animals receiving diluent alone. The collagen content of the capsules was estimated by hydroxyproline analysis of the tissue and by quantitative electron microscopy of collagen bundles. Heat-inactivated rMuIFN-'y failed to reduce the fibrotic response in this assay. These results provide compelling evidence that gamma-interferon can down-regulate collagen synthesis in vivo and suggest the possibility that this lymphokine may be useful in the treatment of disease states characterized by excessive fibrosis.

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Section: Discussionmentioning

confidence: 67%

Gamma-interferon inhibits collagen synthesis in vivo in the mouse.

Granstein¹,

Murphy²,

Margolis³

et al. 1987

J. Clin. Invest.

166

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show abstract

“…Los macrófagos pueden quedar inmovilizados en focos inflamatorios crónicos, sobreviviendo durante varios años 7 . Su presencia se ha observado en cápsulas periprotési-cas, desde los primeros días hasta varios años después de la implantación de próte-sis de silicona 8,10 . Gel de silicona, partículas de elastómero de silicona u otros materiales extraños se han identificado dentro de estas células 9 .…”

Section: Características Microscópicasunclassified

“…En cápsulas de prótesis mamarias de gel de silicona se ha identificado este material dentro de espacios quísticos extracelulares y fagocitado por macrófa-gos 10,12,26,38,39 . Según Thomsen y col 38 , la silicona eliminada es un agente fibrogénico, al provocar una reacción inflamatoria con aumento del número de fibroblastos.…”

Section: Difusión De Gel De Silicona a Través De La Envoltura De La Punclassified

Reacción tisular a las prótesis mamarias: Contractura capsular periprotésica

Escudero

Guarch

Lozano

2005

Anales Sis San Navarra

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RESUMENLas prótesis mamarias de silicona provocan el desarrollo de una envoltura fibrosa o cápsula periprotésica. La contractura de la cápsula, por retracción del tejido fibroso, es la complicación más frecuente e importante de estos implantes. Produce un endurecimiento de grado variable y, en los casos avanzados, deformidad de la mama. Se ha relacionado estrechamente con el tipo de superficie del implante (lisa o texturada) y con la disposición de las fibras de colágeno, habiéndose sugerido que la formación de una cápsula continua, con fibras de colágeno dispuestas paralela y circularmente alrededor de las prótesis lisas, promueve el desarrollo de fuerzas contráctiles concéntricas, que traccionando al unísono producirían la contractura. Con las prótesis texturadas microporosas se ha demostrado una incidencia significativamente más baja de contractura capsular en comparación con las lisas. Se considera que el crecimiento tisular dentro de la estructura microporosa origina fuerzas contráctiles multidireccionales, con tendencia a neutralizarse entre ellas cuando su efecto se suma sobre el implante. La cápsula de estos implantes presenta una zona basal compuesta de múltiples capas de fibras de colágeno alineadas paralelamente, la cual podría contraerse. Sin embargo, la adherencia de las prótesis texturadas microporosas podría contrarrestar las fuerzas contrác-tiles.Palabras clave. Prótesis mamarias. Cápsula periprotésica. Contractura capsular. ABSTRACTSilicone breast prostheses prompt the development of a fibrous casing or periprosthetic capsule. Capsular contracture, due to retraction of the fibrous tissue, is the most frequent and important complication of these implants. It produces varying degrees of hardening and, in advanced cases, deformity of the breast. It has been closely related to the type of surface of the implant (smooth or textured) and with the alignment of the collagen fibers, and it has been suggested that the formation of a continuous capsule, with collagen fibers aligned in parallel and circularly around the smooth prostheses, promotes the development of concentric contractile forces that pulling in unison give rise to contracture. With microporous textured prostheses a significantly lower incidence of capsular contracture has been shown in comparison with smooth prostheses. It is believed that tissue growth within the microporous structure gives rise to multidirectional contractile forces, with a tendency to neutralize one another when their effect is added over the implant. The capsule of these implants presents a base zone composed of multiple layers of collagen fibers aligned in parallel, which might contract. However, the adherence of the microporous textured prostheses might counteract the contractile forces.

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“…Nowadays, the use of implants with smooth surfaces is no longer acceptable due to the fact that they behave differently regarding the occurrence of capsular contracture 11 Therefore, it was decided to use one type of textured prostheses so that responses to the use of propranolol could be verified efficiently without excessive number of variables. In this study, all samples from both groups exhibited a tri-layered capsule as described elsewhere by several scholars in human capsules and animal capsules surrounding textured implants 11,[33][34][35][36][37] .…”

Section: Effect Of Propranolol On Capsular Reaction Around Silicone Imentioning

confidence: 99%

“…The use of conventional histology method to assess inflammation was necessary because it remains the most utilized method to assess capsular inflammation [32][33][34][35][36][37] . Baker's classification and applanation tonometry did not seem very appropriate to investigate contractures or fibrosis in rodent models [16][17] .…”

Section: Effect Of Propranolol On Capsular Reaction Around Silicone Imentioning

confidence: 99%

Effect of propranolol on capsular reaction around silicone implants in guinea pigs

Mesquita

Guimarães²,

Filho³

et al. 2015

Acta Cir. Bras.

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PURPOSE:To evaluate the effect of propranolol on capsular architecture around silicone implants by measuring the inflammation, capsular thickness, and collagen fiber density, using a guinea pig experimental model. METHODS:Thirty six adult male guinea pigs randomly divided into two groups (n=18) were used. Each one received a silicone implant with textured-surface. The capsular tissue around implants from untreated or treated animals with the beta-adrenoceptor antagonist propranolol (10 mg/kg, dissolved in daily water) were analyzed for inflammation by histological scoring, capsular thickness by computerized histometry, and collagen fibers type I and Type III density by picrosirius polarization at different time points (7, 14 or 21 days after silicone implantation). RESULTS:Propranolol treatment reduced inflammation and impaired capsular thickness and delayed collagen maturation around the textured implant. CONCLUSION:Propranolol reduces the risk of developing capsular contracture around silicone implants with textured surface.

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Histology of the capsules causing constrictive fibrosis around breast implants

Cited by 57 publications

References 4 publications

Gamma-interferon inhibits collagen synthesis in vivo in the mouse.

Gamma-interferon inhibits collagen synthesis in vivo in the mouse.

Reacción tisular a las prótesis mamarias: Contractura capsular periprotésica

Effect of propranolol on capsular reaction around silicone implants in guinea pigs

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