Controlled release of transforming growth factor-beta receptor kinase inhibitor from thermosensitive Chitosan-based hydrogel: application for prevention of capsular contracture.

BACKGROUND: Capsular contracture has become the most common complication associated with breast implant. Transforming growth factor-beta (TGF-ß) is well known for a prominent role in fibrotic diseases. Due to the critical role of TGF-ß in pathogenesis of capsular formation, we utilized thermosensitive C/GP hydrogel to controlled release of TGF-ß receptor kinase inhibitor (SD208) and investigated their effects on capsular contracture. METHODS: In vitro degradation and drug release of C/GP hydrogel were performed. Twenty-four rabbits underwent subpanniculus implantation with 30 ml smooth silicone implants and were randomly divided into four groups as follows: Group 1 received saline solution; Group 2 received SD208; Group 3 received SD208-C/GP; Group 4 received C/GP. At 8 weeks, the samples of capsular tissues were analyzed by hematoxylin and eosin and immunohistological staining. The mRNA expression of collagen III and TGF-ß1 was detected by RT-PCR assay. RESULTS: C/GP hydrogel could be applied as an ideal drug delivery vehicle which supported the controlled release of SD208. SD208-C/GP treatment showed a significant reduction in capsule thickness with fewer vessels. The histological findings confirmed that the lower amounts of inflammatory cells and fibroblasts infiltrate in SD208-C/GP group. In contrast, typical capsules with more vessel predominance were developed in control group. We did not observe the same inhibitory effect of SD208 or C/GP treatment on capsular contracture. Moreover, SD208-C/GP therapy yielded an evident down-regulation of collagen III and TGF-ß1 mRNA expression. CONCLUSIONS: This study demonstrated that controlled release of TGF-ß receptor kinase inhibitor from thermosensitive C/GP hydrogel could significantly prevent capsule formation after mammary implants.

[The treatment for complications of polyacrylamide hydrogel injection for augmentation mammaplasty by dual-plane breast augmentation].

OBJECTIVE: To search for the perfect therapy for the complications of breast augmentation by injecting polyacrylamide hydrogel. METHODS: 15 patients whose complications were severe after hydrogel injection were included in this study. Open suction and irrigation of cavity were performed in all patients and all received immediately dual-plane augmentation mammaplasty with silicon gel prostheses. RESULTS: 12 patient were followed up for 3 months to 1 year (mean 6.8 months) and no malposition or deformation occurred. 10 patients (20 breasts) had satisfactory results. The edges of the implant shell could be felt in 2 patients (3 breasts). 1 patient (1 breast) with breast firmness ranked Baker II . CONCLUSIONS: The dual-plane breast augmentation is a valuable technique to treat the complications of polyacrylamide hydrogel injection.

[Reduction mammaplasty with the superior-lateral dermo-glandular pedicle].

OBJECTIVE: To introduce a new technique for reduction mammaplasty appropriate to moderate or heavy hypertrophic breast. METHODS: The superior-lateral dermo-glandular pedicle flap including the nipple-areola complex was created. After the extra glandular tissue was removed, the superior-lateral dermo-glandular pedicle with the nipple-areola complex was rotated, adjusted, sculptured and fixed to the thoracic wall so as to fashion a breast with natural projection and proper shape. This method was used in 4 patients(8 breasts). RESULTS: The operation results were satisfactory without complications. The breasts maintained nice configuration and good function, with well lactating in one case. CONCLUSION: The technique of reduction mammaplasty with the superior-lateral dermo-glandular pedicle is a reasonable method to obtain nice breast configuration and good function.