Mast Cells in the Periprosthetic Breast Capsule

Brazin, Jacqueline; Malliaris, Stephanie D.; Groh, Brittany; Mehrara, Babak J.; Hidalgo, David A.; Otterburn, David M.; Silver, Randi B.; Spector, Jason A.

doi:10.1007/s00266-014-0318-2

Cited by 43 publications

(31 citation statements)

References 24 publications

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“…They reported that Baker grade IV capsules had an increased number of fibroblasts compared with Baker grade I capsules. 15 Prantl et al 16 also reported that capsules with Baker class III or IV contracture were clearly thicker than those with Baker class II contracture after breast augmentation with smooth silicone implants. These results suggest that a thick capsule is caused by the existence of many fibroblasts, meaning that the contracture is strong.…”

Section: Discussionmentioning

confidence: 97%

“…It is generally accepted that myofibroblasts represent key players in the physiological reconstruction of connective tissue after injury and in the generation of the pathological tissue deformations that characterize fibrosis. 14 Brazin et al 15 examined capsules surrounding silicone implants and histologically compared the number of fibroblasts according with the Baker classification. They reported that Baker grade IV capsules had an increased number of fibroblasts compared with Baker grade I capsules.…”

Section: Discussionmentioning

confidence: 99%

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Characterization of the Capsule Surrounding Smooth and Textured Tissue Expanders and Correlation with Contracture

Kuriyama

Ochiai

Inoue

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:Capsular contracture is a common complication after breast augmentation surgery. This study pathologically evaluated the soft-tissue response to surface modifications in both smooth and textured tissue expander prostheses.Methods:Smooth tissue expanders and textured tissue expanders in 5 cases each were used for breast reconstruction after mastectomy. Histological samples were harvested from the capsules when the tissue expanders were replaced by silicone implants. Collagen orientation and cellular responses were assessed histologically. Capsular contracture was evaluated using the Baker classification 6 months and 2 years after the removal of the tissue expander.Results:The capsules surrounding the smooth tissue expanders tended to produce more contracture than those surrounding the textured tissue expanders. The collagen architecture of the capsules of the smooth tissue expanders showed random orientation with fragmentation. Conversely, the capsules of the textured tissue expanders showed parallel orientation with collagen bundles of almost normal structure. Significantly more fibrils of elastin and myofibroblasts were found in the capsules surrounding the smooth tissue than in those surrounding the textured ones.Conclusions:The collagen fibers surrounding the smooth tissue expanders could be cracked during expansion, which may lead to scarring and contracture. Conversely, the collagen orientation surrounding the textured tissue expanders was excellent. Moreover, the increase in elastic fibers and myofibroblasts in the capsules surrounding the smooth tissue expanders may be associated with in vivo contraction patterns. Therefore, the surface type of tissue expanders affects capsular contraction after replacement with definitive implants.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Characterization of the Capsule Surrounding Smooth and Textured Tissue Expanders and Correlation with Contracture

Kuriyama

Ochiai

Inoue

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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“…Macrophages, lymphocytes and fibroblasts have been reported to be the predominant cell types within the capsule. Fibroblasts accumulate at the 'contact zone' of the implant and the capsule [ 6 17 18 ], and it has been reported that the number of fibroblasts within the capsule correlates with the Baker grade, with an increased number found in grade IV capsular contracture when compared to grade I [ 19 ]. As fibroblasts produce collagen, they have been linked to the initial formation of the capsule.…”

Section: Pathogenesis Of Capsular Contracturementioning

confidence: 99%

“…As fibroblasts produce collagen, they have been linked to the initial formation of the capsule. Histological evaluation of capsular tissue has shown that the majority of the tissue is made up of uniformly distributed collagen fibres [ 3 19 ]. The orientation and organisation of the collagen fibres appears to change as contracture severity worsens: the fibres become thicker and establish themselves in cable-like bundles which orientate themselves perpendicular to the fibroblasts to produce a helical orientation as the severity increases [ 20 ].…”

Section: Pathogenesis Of Capsular Contracturementioning

confidence: 99%

Capsular Contracture after Breast Augmentation: An Update for Clinical Practice

2015

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Capsular contracture is the most common complication following implant based breast surgery and is one of the most common reasons for reoperation. Therefore, it is important to try and understand why this happens, and what can be done to reduce its incidence. A literature search using the MEDLINE database was conducted including search terms 'capsular contracture breast augmentation', 'capsular contracture pathogenesis', 'capsular contracture incidence', and 'capsular contracture management', which yielded 82 results which met inclusion criteria. Capsular contracture is caused by an excessive fibrotic reaction to a foreign body (the implant) and has an overall incidence of 10.6%. Risk factors that were identified included the use of smooth (vs. textured) implants, a subglandular (vs. submuscular) placement, use of a silicone (vs. saline) filled implant and previous radiotherapy to the breast. The standard management of capsular contracture is surgical via a capsulectomy or capsulotomy. Medical treatment using the off-label leukotriene receptor antagonist Zafirlukast has been reported to reduce severity and help prevent capsular contracture from forming, as has the use of acellular dermal matrices, botox and neopocket formation. However, nearly all therapeutic approaches are associated with a significant rate of recurrence. Capsular contracture is a multifactorial fibrotic process the precise cause of which is still unknown. The incidence of contracture developing is lower with the use of textured implants, submuscular placement and the use of polyurethane coated implants. Symptomatic capsular contracture is usually managed surgically, however recent research has focussed on preventing capsular contracture from occurring, or treating it with autologous fat transfer.

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“…According to previously published reports, fibroblast numbers are increased in accordance with the Baker grade of capsular tissue. Mast cells in the capsular tissue contain mediators that may activate neighboring fibroblasts [13]. Indeed, fibroblasts produce the major components of capsular tissue in the form of collagen fibers.…”

Section: Introductionmentioning

confidence: 99%

Effects of Medical Chitosan on Capsular Formation Following Silicone Implant Insertion in a Rabbit Model

Ren

et al. 2016

Aesth Plast Surg

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This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Mast Cells in the Periprosthetic Breast Capsule

Cited by 43 publications

References 24 publications

Characterization of the Capsule Surrounding Smooth and Textured Tissue Expanders and Correlation with Contracture

Characterization of the Capsule Surrounding Smooth and Textured Tissue Expanders and Correlation with Contracture

Capsular Contracture after Breast Augmentation: An Update for Clinical Practice

Effects of Medical Chitosan on Capsular Formation Following Silicone Implant Insertion in a Rabbit Model

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