Erratum: Correction of Figure: Simvastatin Reduces Capsular Fibrosis around Silicone Implants.

This corrects the article on p. 1273 in vol. 31, PMID: 27478339.

Simvastatin Reduces Capsular Fibrosis around Silicone Implants.

Capsular fibrosis and contracture occurs in most breast reconstruction patients who undergo radiotherapy, and there is no definitive solution for its prevention. Simvastatin was effective at reducing fibrosis in various models. Peri-implant capsular formation is the result of tissue fibrosis development in irradiated breasts. The purpose of this study was to examine the effect of simvastatin on peri-implant fibrosis in rats. Eighteen male Sprague-Dawley rats were allocated to an experimental group (9 rats, 18 implants) or a control group (9 rats, 18 implants). Two hemispherical silicone implants, 10 mm in diameter, were inserted in subpanniculus pockets in each rat. The next day, 10-Gy of radiation from a clinical accelerator was targeted at the implants. Simvastatin (15 mg/kg/day) was administered by oral gavage in the experimental group, while animals in the control group received water. At 12 weeks post-implantation, peri-implant capsules were harvested and examined histologically and by real-time polymerase chain reaction. The average capsular thickness was 371.2 µm in the simvastatin group and 491.2 µm in the control group. The fibrosis ratio was significantly different, with 32.33% in the simvastatin group and 58.44% in the control group (P < 0.001). Connective tissue growth factor (CTGF) and transforming growth factor (TGF)-ß1 gene expression decreased significantly in the simvastatin group compared to the control group (P < 0.001). This study shows that simvastatin reduces radiation-induced capsular fibrosis around silicone implants in rats. This finding offers an alternative therapeutic strategy for reducing capsular fibrosis and contracture after implant-based breast reconstruction.

The Relationship Between Facial Asymmetry and Nasal Septal Deviation.

PURPOSE: Facial asymmetry is not uncommon in normal individuals. Nasal septum is known to play a direct and indirect role in the premaxillary and maxillary growth. In this study, we aimed to evaluate the integrated relationship between nasal septal deviation and facial asymmetry by means of 3-dimensional analysis in a larger number of patients than those in previous studies. METHODS: From April 2011 to March 2014, a total of 60 subjects were included. They had facial asymmetry confirmed by facial three-dimensional CT. Patients who had a history of facial bone fracture or congenital craniofacial deformities were excluded. Facial asymmetry was analyzed in 3 aspects: facial width, projection, and height. Nasal septal deviations included horizontal and vertical deviations. RESULTS: The patients with right horizontal nasal septal deviation to the right had a wider right side of the face (P = 0.028). Facial asymmetry was observed more frequently in the right side of the face in the current study (P = 0.020). There were no other close relationships between nasal septal deviation and facial asymmetry. CONCLUSION: We demonstrate that there is a strong relationship between nasal septal deviation to the right and a wider right hemiface in facial asymmetry patients. Also, facial asymmetry patients tend to have a wider right side of the face compared to the left side.

A Comparative Study of CG CryoDerm and AlloDerm in Direct-to-Implant Immediate Breast Reconstruction.

BACKGROUND: To date, various types of acellular dermal matrix (ADM) have been developed for clinical use. AlloDerm is the most familiar type of ADM to most surgeons in breast reconstruction. It is prepared by freeze-drying. CG CryoDerm is the first form of ADM that requires no drying process. Therefore, theoretically, it has a higher degree of preservation of the dermal structures than AlloDerm. We conducted this study to compare the clinical course and postoperative outcomes of patients who underwent direct-to-implant breast reconstructions using AlloDerm and those who did using CG CryoDerm. METHODS: We performed a retrospective analysis of the medical records in a consecutive series of 50 patients who underwent direct-to-implant breast reconstruction using AlloDerm (n=31) or CryoDerm (n=19). We then compared the clinical course and postoperative outcomes of the two groups based on the overall incidence of complications and the duration of drainage. RESULTS: The mean follow-up period was 16 months. There were no significant differences in the overall incidence of complications (seroma, infection, skin flap necrosis, capsular contracture, and implant loss) between the two groups. Nor was there any significant difference in the duration of drainage. CONCLUSIONS: CG CryoDerm has the merits of short preparation time and easy handling during surgery. Our results indicate that CG CryoDerm might be an alternative allograft material to AlloDerm in direct-to-implant breast reconstruction.