Aesthetic Plastic Surgery

, Volume 34, Issue 4, pp 481–485 | Cite as

Histological Features of Periprosthetic Mammary Capsules: Silicone vs. Polyurethane

  • Franco Bassetto
  • Carlotta Scarpa
  • Elio Caccialanza
  • Maria Cristina Montesco
  • Patrizia Magnani
Original Article



Periprosthetic capsules are a common reaction of the body to silicone or polyurethane breast implants. The aim of this study was to evaluate similarities and differences in the histological features of periprosthetic capsules surrounding silicone implants and polyurethane foam-coated implants and to correlate those features with the age of the implants.


Tissues were studied from 41 periprosthetic capsules surrounding textured prostheses and from 20 capsules surrounding polyurethane foam-coated implants. For each sample we evaluated synovial metaplasia, density of collagen fibers or fibrosis, orientation of collagen fibers, and foreign body reaction (granulomatous reaction).


Synovial metaplasia was seen in the capsular tissue from both types of implant, but more so from capsules surrounding polyurethane implants more than 5 years old. The density and orientation of the collagen fibers and the foreign body reaction were very similar for the two types of implant.


Breast capsule Silicone implant Polyurethane implant Synovial metaplasia Collagen fibres Foreign body reaction 


  1. 1.
    Brand KG (1984) Polyurethane-coated silicone implants and the question of capsular contracture. Plast Reconstr Surg 73(3):498CrossRefPubMedGoogle Scholar
  2. 2.
    Bucky LP, Ehrlich HP, Sohoni S, May JW Jr (1994) The capsule quality of saline-filled smooth silicone, textured silicone, and polyurethane implants in rabbits: a long-term study. Plast Reconstr Surg 93(6):1123–1131 discussion 1132-1133CrossRefPubMedGoogle Scholar
  3. 3.
    Chase DR, Oberg KC, Chase RL, Malott RL, Weeks DA (1994) Pseudoepithelialization of breast implant capsules. Int J Surg Pathol 1(3):151–154CrossRefGoogle Scholar
  4. 4.
    Del Rosario AD, Bui HX, Petrocine S, Sheehan C, Pastore J, Singh J, Ross JS (1995) True synovial metaplasia of breast implant capsules: a light and electron microscopic study. Ultrastruct Pathol 19(2):83–93CrossRefPubMedGoogle Scholar
  5. 5.
    Batra M, Bernard S, Picha G (1995) Histologic comparison of breast implant shells with smooth, foam, and pillar microstructuring in a rat model from 1 day to 6 months. Plast Reconstr Surg 95(2):354–363CrossRefPubMedGoogle Scholar
  6. 6.
    Handel N, Jensen JA, Black Q, Waisman JR, Silverstein MJ (1995) The fate of breast implants: a critical analysis of complications and outcomes. Plast Reconstr Surg 96(7):1521–1533CrossRefPubMedGoogle Scholar
  7. 7.
    Ko CY, Ahn CY, Ko J, Chopra W, Shaw WW (1996) Capsular synovial metaplasia as a common response to both textured and smooth implants. Plast Reconstr Surg 97(7):1427–1433 discussion 1434-1435CrossRefPubMedGoogle Scholar
  8. 8.
    Wyatt LE, Sinow JD, Wollman JS, Sami DA, Miller TA (1998) The influence of time on human breast capsule histology: smooth and textured silicone surfaced implants. Plast Reconstr Surg 102(6):1922–1931CrossRefPubMedGoogle Scholar
  9. 9.
    Siggelkow W, Faridi A, Spiritus K, Klinge U, Rath W, Klosterhalfen B (2003) Histological analysis of silicone breast implant capsule and correlation with capsular contracture. Biomaterials 24(6):1101–1109CrossRefPubMedGoogle Scholar
  10. 10.
    Raso DS, Greene WB, Metcalf JS (1994) Synovial metaplasia of a periprosthetic breast capsule. Arch Pathol Lab Med 118(3):249–251PubMedGoogle Scholar
  11. 11.
    Raso DS, Greene WB (1995) Synovial metaplasia of a periprosthetic breast capsule surrounding a polyurethane foam breast prosthesis. Ann Plast Surg 35(2):201–203CrossRefPubMedGoogle Scholar
  12. 12.
    Copeland M, Choi M, Bleiweiss IJ (1994) Silicone breakdown and capsular synovial metaplasia in textured-wall saline breast prostheses. Plast Reconstr Surg 94(5):628–633 discussion 634-636CrossRefPubMedGoogle Scholar
  13. 13.
    Poeppl N, Schreml S, Lichtenegger F, Lenich A, Eisenmann-Klein M, Prantl L (2007) Does the surface structure of implants have an impact on the formation of a capsular contracture? Aesthetic Plast Surg 31(2):133–139CrossRefPubMedGoogle Scholar
  14. 14.
    Hester T Jr, Ford NF, Gale PJ, Hammett JL, Raymond R, Turnbull D, Frankos VH, Cohen MB (1997) Measurement of 2,4-toluenediamine in urine and serum samples from women with Même or Replicon breast implants. Plast Reconstr Surg 100:1291–1298CrossRefPubMedGoogle Scholar
  15. 15.
    Giachero E (1992) Materiali sintetici in chirurgia plastica, Ed. CortinaGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2010

Authors and Affiliations

  • Franco Bassetto
    • 1
  • Carlotta Scarpa
    • 1
    • 4
  • Elio Caccialanza
    • 2
  • Maria Cristina Montesco
    • 3
  • Patrizia Magnani
    • 2
  1. 1.Plastic Surgery ClinicUniversity of PadovaPadovaItaly
  2. 2.Plastic Surgery ClinicPaviaItaly
  3. 3.Institute of AnatomopathologyUniversity of PadovaPadovaItaly
  4. 4.Plastic and Reconstructive Surgery UnitUniversity of PadovaPadovaItaly

Personalised recommendations