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Histological analysis of capsule formation around silicone implants and comparison with titanium-coated silicone implants in rats

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Abstract

Silicone implants have been used for breast augmentation for more than 45 years. Complications, in particular capsular contracture, occur with an incidence of <10% and up to 60%. We investigated the influence of the surface of breast implants on the formation of capsular contracture by comparing silicone with titanium-coated silicone. Seventeen smooth saline-filled silicone (group A) and 14 saline-filled titanium-coated silicone (group B) implants were implanted in female Wistar rats. After 12 and 36 weeks, the implants and capsules were extracted; histological and immunohistochemical staining was performed. The evaluation of the capsules was performed by two examiners in a double-blinded manner. Histologically, no significant difference in total capsule thickness was found. There was a significant difference in synovial-like metaplasia layer (SLM) thickness between groups A and B (p = 0.041). Regarding implantation time (12 vs. 36 weeks), a significant difference was found in SLM thickness (p = 0.021). Immunohistochemical staining indicated a significantly lower infiltration with inflammatory cells in group B. A significant correlation (p = 0.019) between a thick SLM layer and inflammatory cell infiltration was detected. Titanium-coated silicone implants reduce SLM thickness and capsular inflammatory cell infiltration. These findings postulate that titanium-coated silicone implants might point out a new chance in the prevention of capsular contracture.

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Authors and Affiliations

  1. Plastic Surgery, Hand Surgery, Burn Unit, University Hospital Schleswig-Holstein Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany

    Philipp Alexander Bergmann, Thomas Lange, Frank Siemers, Thomas Namdar, Peter Leonhard Stollwerck, Stefan Zimmermann & Peter Mailänder

  2. Plastic and Hand Surgery, Klinikum rechts der Isar, Technischen Universität München, Ismaniger Str. 22, 81675, Munich, Germany

    Hans-Günther Machens & Jörn Andreas Lohmeyer

Authors
  1. Philipp Alexander Bergmann
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  2. Thomas Lange
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  3. Frank Siemers
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  4. Hans-Günther Machens
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  5. Jörn Andreas Lohmeyer
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  6. Thomas Namdar
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  7. Peter Leonhard Stollwerck
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  8. Stefan Zimmermann
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  9. Peter Mailänder
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Correspondence to Thomas Lange.

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Bergmann, P.A., Lange, T., Siemers, F. et al. Histological analysis of capsule formation around silicone implants and comparison with titanium-coated silicone implants in rats. Eur J Plast Surg 35, 19–24 (2012). https://doi.org/10.1007/s00238-011-0579-9

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  • DOI: https://doi.org/10.1007/s00238-011-0579-9

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