Options for capsulotomy and capsulectomy in the treatment of capsular contracture: are there clinical treatment alternatives to surgery? A literature review

Oliveira, Kleiton Cardozo De; Pereira, Rui; Salgado, I.; Baptista, Eduardo; Arantes, Guilherme Campelo; Luna, Igor Chaves Gomes

doi:10.5935/2177-1235.2015rbcp0127

Cited by 1 publication

(3 citation statements)

References 23 publications

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“…However, capsular contracture (CC), which induces implant deformities and pain in an advanced stage, is the most severe side effect with the use of silicone breast implants [ 1 , 2 ]. Symptoms range from breast hardening and discomfort to complete breast and volume collapses due to excessive production of a fibrous capsule around the implant [ 3 ]. CC has an occurrence rate of 8% to 45% [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Several measures are recommended to reduce the incidence of CC, such as surface modifications of silicone breast implants with micro-/nanotextured materials, anti-adhesive and/or antibacterial materials, and drug coating using triamcinolone, tranilast, montelukast, and zafirlukast, which have reported varying levels of success [ 3 , 12 ]. For drug coating, steroids are used commonly to promote anti-inflammatory activity, and glucocorticoids are considered good candidates for the prevention of CC caused by overactive inflammation [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Triamcinolone (TA) is an FDA-approved medication that is normally administered not continuously but rather as a bolus through local injection. Therefore, TA can be a good optional drug for reducing fibrosis when accompanied with a suitable carrier [ 3 , 4 ]. The local, sustained supply of such an anti-inflammatory drug around a silicone breast implant would therefore be useful to modulate the upregulated inflammation and thus avoid capsular contracture [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Silicone Breast Implant Coated with Triamcinolone Inhibited Breast-Implant-Induced Fibrosis in a Porcine Model

Nam

Shin

et al. 2021

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Cosmetic silicone implants for breast reconstruction often lead to medical complications, such as abnormally excessive fibrosis driven by foreign body granulomatous inflammation. The purpose of this study was to develop a silicone breast implant capable of local and controlled release of a glucocorticoid drug triamcinolone acetonide (TA) for the prevention of silicone-breast-implant-induced fibrosis in a Yorkshire pig model (in vivo). Implants were dip-coated in a TA solution to load 1.85 μg/cm2 of TA in the implant shell, which could release the drug in a sustained manner for over 50 days. Immunohistochemical analysis for 12 weeks showed a decline in tumor necrosis factor-α expression, capsule thickness, and collagen density by 82.2%, 55.2%, and 32.3%, respectively. Furthermore, the counts of fibroblasts, macrophages, and myofibroblasts in the TA-coated implants were drastically reduced by 57.78%, 48.8%, and 64.02%, respectively. The TA-coated implants also lowered the expression of vimentin and α-smooth muscle actin proteins, the major profibrotic fibroblast and myofibroblast markers, respectively. Our findings suggest that TA-coated silicone breast implants can be a promising strategy for safely preventing fibrosis around the implants.

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