Oestrogen receptor-alpha and -beta expression in breast implant capsules: Experimental findings and clinical correlates

Capsular Contracture after Breast Augmentation: An Update for Clinical Practice

“…Myofibroblasts are contractile fibroblasts which are thought to provide a contractile force which decreases the surface area of the capsule whilst the collagen matrix remodels and stabilises the contracture. Interestingly, these cells have been found to express oestrogen receptor-α (ER-α) and/or β (ER-β), which are acted on by 17-β-oestrodiol to increase their contractile force [ 21 ]. In the same study, Persichetti et al [ 21 ] investigated the effect of anti-oestrogenic therapy through administration of Tamoxifen.…”

Toll-Like Receptor 4 Expression in Human Breast Implant Capsules

“…Moreover, a previous study by Persichetti and colleagues demonstrated lower contracture severity in patients undergoing antiestrogenic therapy during the perioperative period. 6 Consistently, in other fibrotic processes, tamoxifen (a selective estrogen receptor modulator) decreased myofibroblast proliferation, contraction, and TGF-β production, 29,30 thus leading to its clinical use in retroperitoneal fibrosis, keloids, and hypertrophic scarring. 31,32 The effect of the hormonal asset following breast implant placement was also reported by Dancey and colleagues: in a case series of 1400 patients, the authors found pregnancy to be a risk factor for capsular contracture.…”

“…4,24 These cells are predominant in the middle layer of capsular tissue, where profibrotic and proproliferative cytokines, such as transforming growth factor (TGF)-β and insulin-like growth factors 1 and 2, are mainly expressed. 6,25,26 17β-Estradiol increases the production of TGF-β and fibronectin, which are among the main stimuli involved in myofibroblast differentiation and contraction. 27,28 The main receptors for this hormone are estrogen receptor-α and estrogen receptor-β.…”

“…Coleman and colleagues 24 and Persichetti et al 6 found no ultrastructural, histologic, or contractile difference between capsules surrounding tissue expanders and definitive implants. Although the general three-layered structure is maintained, 40 some histologic differences may be found between smooth and textured implants, mainly in the long-term period, 41 and in capsules surrounding implants placed for cosmetic purposes.…”

“…Moreover, they reported a lower contracture severity in patients undergoing antiestrogenic therapy. 6 Fibroblast activation may result from estrogen receptor stimulation 7 and from other different stimuli, 8 such as toll-like receptor interactions with their ligands. 9 Generally, toll-like receptors are transmembrane proteins residing at cell surfaces or in the membranes of intracellular compartments.…”