The Histological Composition of Capsular Contracture Focussed on the Inner Layer of the Capsule: An Intra-Donor Baker-I Versus Baker-IV Comparison

Bakker, Erik de; Broek, L. J. van den; Ritt, Marco J.P.F.; Gibbs, Susan; Niessen, Frank B.

doi:10.1007/s00266-018-1211-1

Cited by 35 publications

(45 citation statements)

References 33 publications

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“…The peri-implant capsules were formed by fibrous connective tissue, where the content of fibroblasts, myofibroblasts and blood vessels, as well as the alignment, density and architectonics of the collagen bundles differed between the studied groups and changed with the time. The structure of the peri-implant capsules in PLA 0 group was similar to the capsules observed previously around long-term resorbable biomaterials including PLA and polylactic-co-glycolic sutures, textured silicone breast implants [74] and even cochlear implant electrodes [75]. On the other hand, the granulomatous inflammation (emerged in the formation of FBGC) is a typical immune response not only to synthetic biomaterials, but to various xenogeneic structures in the absence of a specific resorption mechanism [76].…”

Section: Discussionsupporting

confidence: 75%

Local Delivery of Pirfenidone by PLA Implants Modifies Foreign Body Reaction and Prevents Fibrosis

et al. 2021

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Peri-implant fibrosis (PIF) increases the postsurgical risks after implantation and limits the efficacy of the implantable drug delivery systems (IDDS). Pirfenidone (PF) is an oral anti-fibrotic drug with a short (<3 h) circulation half-life and strong adverse side effects. In the current study, disk-shaped IDDS prototype combining polylactic acid (PLA) and PF, PLA@PF, with prolonged (~3 days) PF release (in vitro) was prepared. The effects of the PLA@PF implants on PIF were examined in the rabbit ear skin pocket model on postoperative days (POD) 30 and 60. Matching blank PLA implants (PLA0) and PLA0 with an equivalent single-dose PF injection performed on POD0 (PLA0+injPF) served as control. On POD30, the intergroup differences were observed in α-SMA, iNOS and arginase-1 expressions in PLA@PF and PLA0+injPF groups vs. PLA0. On POD60, PIF was significantly reduced in PLA@PF group. The peri-implant tissue thickness decreased (532 ± 98 µm vs. >1100 µm in control groups) approaching the intact derma thickness value (302 ± 15 µm). In PLA@PF group, the implant biodegradation developed faster, while arginase-1 expression was suppressed in comparison with other groups. This study proves the feasibility of the local control of fibrotic response on implants via modulation of foreign body reaction with slowly biodegradable PF-loaded IDDS.

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Section: Discussionsupporting

confidence: 75%

Local Delivery of Pirfenidone by PLA Implants Modifies Foreign Body Reaction and Prevents Fibrosis

et al. 2021

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“…Histological analysis of the capsular layers in a previous study further suggested the presence of synovial metaplasia within the inner layer, particularly in healthy, uncontracted Baker I capsules, suggesting a protective factor [ 36 ]. The middle layer has been observed in line with the capsular border, while the outer layer is loosely arranged [ 36 ]. In our histological analysis, we could confirm this type of arrangement in three layers.…”

Section: Discussionmentioning

confidence: 99%

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

Kuehlmann

Zucal

Bonham

et al. 2021

BMC Mol and Cell Biol

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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.

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“…Histological analysis of the capsular layers in a previous study further suggested the presence of synovial metaplasia within the inner layer, particularly in healthy, uncontracted Baker I capsules, suggesting a protective factor [33]. The middle layer has been observed in line with the capsular border , while the outer layer is loosely arranged [33].…”

Section: Discussionmentioning

confidence: 89%

SEM and TEM for Identification of Capsular Fibrosis and Cellular Behavior Around Breast Implants – a Descriptive Analysis

Kuehlmann

Zucal

Bonham

et al. 2021

Preprint

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BackgroundCapsular 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).ResultsMiniature 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.ConclusionsThis murine model accurately recapitulates CF found in humansand can be utilized for future research on cellular invasion in capsular fibrosisThis 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.

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The Histological Composition of Capsular Contracture Focussed on the Inner Layer of the Capsule: An Intra-Donor Baker-I Versus Baker-IV Comparison

Abstract: This journal requires that authors assign a level of evidence to each article. 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 .

Cited by 35 publications

References 33 publications

Local Delivery of Pirfenidone by PLA Implants Modifies Foreign Body Reaction and Prevents Fibrosis

Local Delivery of Pirfenidone by PLA Implants Modifies Foreign Body Reaction and Prevents Fibrosis

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

SEM and TEM for Identification of Capsular Fibrosis and Cellular Behavior Around Breast Implants – a Descriptive Analysis

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