SEM and TEM for identification of capsular fibrosis and cellular behavior around breast implants – a descriptive analysis

Abstract

Background Capsular fibrosis (CF) is the most common long-term complication in implant-based breast augmentation. It is well accepted that the foreign body response (FBR) instigates the development of fibrotic disease. Our study aims to compare murine and human samples of CF and describe the cellular and extracellular matrix (ECM) composition using scanning and transmission electron microscopy (SEM and TEM). Results Miniature microtextured silicone breast implants were implanted in mice and subsequently harvested at days 15, 30, and 90 post-operation. Isolated human capsules with the most aggravated form of CF (Baker IV) were harvested post-operation. Both were analyzed with SEM and TEM to assess cellular infiltration and ECM structure. An architectural shift of collagen fiber arrangement from unidirectional to multidirectional was observed at day 90 when compared to days 15 and 30. Fibrosis was observed with an increase of histiocytic infiltration. Moreover, bacterial accumulation was seen around silicone fragments. These findings were common in both murine and human capsules. Conclusions This murine model accurately recapitulates CF found in humans and can be utilized for future research on cellular invasion in capsular fibrosis. This descriptive study helps to gain a better understanding of cellular mechanisms involved in the FBR. Increases of ECM and cellularity were observed over time with SEM and TEM analysis.

Quantitative Proteomic Characterization of Foreign Body Response towards Silicone Breast Implants Identifies Chronological Disease-Relevant Biomarker Dynamics

“…However, COL3 was detected on the SMI surface, significantly upregulated on days 3 and 4 post-op, and we found higher levels of COL3 compared to COL1 in the acute wound proteome (Supplementary Materials Table S20). Here we manifest the role of COL1 in late fibrosis [81,82], moreover, our new data may also provide information on the chronological production of other collagens and non-collagenous proteins.…”

Quantitative Proteomic Characterization of Foreign Body Response towards Silicone Breast Implants Identifies Chronological Disease-Relevant Biomarker Dynamics

“…However, COL3 was detected on the SMI surface, significantly upregulated on days 3 and 4 post-op and we found higher levels of COL3 compared to COL1 in the acute wound proteome (Table 3). We not only manifest the role of COL1 in late fibrosis [84,85], our new data may provide information on the chronological production of other collagens and non -collagenous proteins.…”

A Method to Evaluate the Ultrastructure of Free Cells by Scanning Electron Microscopy

“…Several approaches have been proposed for the adherence free cells to substrates and analysis by SEM. Among the most conventional substrates are the carbon-coated cellulose acetate membranes (Millipore) [9], Formvar resin applied directly on the stubs [10], freeze-fractured agarose in 50% dimethyl sulfoxide followed by maceration with OsO4 [11], copper grids covered with a Formvar film [12], polycarbonate membranes (Nucleopore) [13], direct sample mounting on stubs [14], etc. Clearly, methodologies are in constant revision, and it is important to determine whether the substrate is biologically inactive or if it can affect cell structure and function [15].…”

“…In the current method, a series of five ethanol concentrations (50%, 70%, 90%, 100%, and 100%) were used and the dehydration time (5 min) was the same in each concentration. This ethanol sequence has been previously used by Kuehlmann et al (2021) [14].…”