ABSTRACT
The authors implanted 60 isogenic Balb-C mice, with smooth, fragmented (rough) and poliurethane-coated silicone to evalute the histologic reactions and collagen organization related to these prosthesis. The microscopic observation disclosed the same histologic reaction against the three types of implants. Macrophage-like cells were observed in contact with the prosthesis. The outer portion was constituted, predominantly, by fibroblast-like cells and collagen deposits. The prosthesis geometric shape (or surface) was supposed to orientate the capsule extracelular matrix synthesis. Thus, the authors suggest that the rate decrease of capsule contracture in rough and poliurethane-coated prosthesis is related to a lesser "cell-to-cell"or cell-to-collagen-to-cell" alignment showed by those inflammatory reactions. The use of silicone prosthesis regarding the augmentation of breast volume has been the most widely performed procedure related to this subject. Since its creation by Cronin and Gerow(1), i became evident that the most frequent late complication has been the capsule contracture (2-4). Escape of the silicone gel from the prosthesis lumen, hematoma as well as underclinic infections, has been pointed as etiologic factors(5-15). Thus, some prophylactic measures as the antisepsis of the nipple-areola complex, topic and systemic antibiotic prophylaxis, vitamin E, local massage and external compression, has been advocated by some specialists, but with non-effective results(16,20). Remarkable results were reached in the incidence decrease of the capsule contracture with the use of inflatable prosthesis containing saline solution, associated or not to the steroids, poliurethane-coated prosthesis or rough prosthesis(21,32). Although the literature discloses differences in the inflammatory reactions surrounding the different types of prosthesis surfaces(25), it has not been enphasized that those differences lead to a specific arrangement of the collagen fibers adjacent to the prosthesis and so, altering the capsule contracture rate. This paper was produced to evaluate the histologic reactions and the formation of the collagen capsule adjacent to the different types of prosthesis surface.
Subject(s)
Animals , Mice , Breast Implants/adverse effects , Inflammation/etiology , Polyurethanes , Silicones , Mice, Inbred BALB CABSTRACT
The authors documentation on histologic alterations observed in the autologous adipose grafts disclosed the tissue capacity to establish nutrition through plasmatic imbibition at approximately 1,5 mm from the vascularized edges. Thus, the findings suggest that fragmented adipose tissue should be proceeded through syringes and cannulae in thin threads or vertical, horizontal and non-contiguous planes, not exceeding 3,0 mm in thickness. Moreover, the time interval between the first and second grafting sessions should be approximately 35 days. There are two distinct stages related to the use of adipose grafts for the body contour remodeling. Until the 195O's, the grafting was proceeded using single blocks harvested from the donor sites with sharp instruments(1-4). Peer presented histologic studies suggesting the adipose graft viability by this technique, and documented a loss of weight and volume of about 50 per cent one year after transplantation(5,6). The adipose graft application reemerged later, in 1984(7), after the first publication on suction assisted lipectomy (SAL) and its sequelae. The fat grafts were obtained with cannulae or needles, and transplanted as small cylindric or cuboidal blocks, under negative and positive pression regimen, respectively. Studies on this subject were published demonstrating remarkable resorption rates and difficulties in clinical evaluation(8-12). Our recent studies on the histologic alternations and adipose viability in autogenous fat transplantations, using an experimental model(l3) as well as human cases(14), led us to suggest some parameters related to the transplant thickness and grafting intervals in clinical applications.