Abstract
Background
Capsular contracture is the main complication related to breast silicone implants, and its prevention remains a medical challenge. The authors present experimental research examining the effect of external ultrasound on the formation and contracture of peri-implant capsules.
Methods
In this study, 42 male Wistar rats had a 2-mm smooth surface implant placed in a dorsal submuscular pocket. They then were separated into “ultrasound” and “control” groups that received repeated external applications either with or without the ultrasound power on. Ultrasound applications were given three times a week for a period of 90 days. After that, both groups were housed under the same conditions with no application scheduled. Five animals of each group, killed at 30, 60, 90, and 180 days, had their implants removed along with the capsule, which received a special histologic preparation via annular sectioning that provided wide circumferential observation of the capsular tissue. Sections were stained with hematoxylin/eosin stain, Masson’s trichrome stain, and Pricrosirius Red stain for regular microscopic evaluation under normal and polarized light.
Results
Histologic data showed that capsules from the ultrasound and control groups had statistically significant differences. Ultrasound application developed a capsular architecture similar to that shown within textured silicone implants, and its effect had an early definition with subsequent stabilization.
Conclusion
The authors conclude that early and repeated external ultrasound application enhances the thickness, cellular count, and vascularity of smooth silicone capsular tissue, whereas it diminishes the pattern of parallel orientation of collagen fibers.
Similar content being viewed by others
References
Silversmith PE (1984) Ultrasound for capsular contracture of the breast (letter). Plast Reconstr Surg 73:500
Herhahn FT (1984)Ultrasound and capsular contracture (letter). Plast Reconstr Surg 74:574
Planas J, Migliano E, Wagenfuhr J, et al. (1997) External ultrasonic treatment of capsular contractures in breast implants. Aesth Plast Surg 21:395–397
Planas J, Cervelli V, Planas G (2001) Five-year experience on ultrasonic treatment of breast contractures. Aesth Plast Surg 25:89–93
Clugston PA, Perry LC, Hammond DC, et al. (1994) A rat model for capsular contracture: The effects of surface texturing. Ann Plast Surg 33:595–599
Caffee HH (1990) Textured silicone and capsular contracture. Ann Plast Surg 24:197–199
Bern S, Burd A, May JW Jr (2002) The biophysical and histologic properties of capsules formed by smooth and textured silicone implants in the rabbit. Plast Reconstr Surg 89:1037–1042, discussion 1043–1044
Bucky LP, Ehrlich HP, Sohoni S, et al. (1994) The capsule quality of saline-filled smooth silicone, textured silicone and polyurethane implants in rabbits: A long-term study. Plast Reconstr Surg 93:1123–1131
Picha GJ, Goldstein JA, Sthor E (1990) Natural-Y Même polyurethane versus smooth silicone: Analysis of the soft-tissue interaction from 3 days to 1 year in the rat animal model. Plast Reconstr Surg 85:903–916
Smahel J, Hurwitz PJ, Hurwitz N (1993) Soft tissue response to textured silicone implants in an animal experiment. Plast Reconstr Surg 92:474–479
Batra M, Bernard S, Picha G (1995) Histologic comparison of breast implant shells with smooth, foam, and pillar microstructuring in a rat model from 1 day to 6 months. Plast Reconstr Surg 95:354–363
Raposo-Do-Amaral CM, Tiziani V, Trevisan MA, Pires CH, Palhares FB (1992) Capsular contracture and silicone gel: Experimental study. Aesth Plast Surg 16:261–264
Frangou J, Kanellaki M (2002) The effect of local application of mitomycin-C on the development of capsule around silicone implants in the breast: An experimental study in mice. Aesth Plast Surg 25:118–128
Haar GT (1978) Basic physics of therapeutic ultrasound. Physiotherapy 64:100–103
Haar GT (1999) Therapeutic ultrasound. Eur J Ultrasound 9:3–9
Young SR, Dyson M (1990) Effect of therapeutic ultrasound on the healing of full-thickness excised skin lesions. Ultrasonics 28:175–180
Karnes JL, Burton HW (2002) Continuous therapeutic ultrasound accelerates repair on contraction-induced skeletal muscle damage in rats. Arch Phys Med Reabil 83:1–4
Speed CA (2001) Therapeutic ultrasound in soft tissue lesions. Rheumatology 40:1331–1336
Baker KG, Robertson VJ, Duck FA (2001) A review of therapeutic ultrasound: Biophysical effects. Phys Ther 81:1351–1358
Duck FA (2001) A review of therapeutic ultrasound: Biophysical effects. Phys Ther 81:1351–1358
Rubin A, Hoefflin SM (1999) Treatment of postoperative bruising and edema with external ultrasound and manual linfatic drainage. Plast Reconstr Surg 103:1759–1760
Gasperoni C, Salgarello M (2000) The use of external ultrasound combined with superficial subdermal liposuction. Ann Plast Surg 45:369–373
Mendes FH (2000) External ultrasound-assisted lipoplasty from our own experience. Aesth Plast Surg 24:270–274
Góes JC, Landecker A (2002) Ultrasound-assisted lipoplasty (UAL) in breast surgery. Aesth Plast Surg 26:1–9
Viterbo F, Mendes FH, Ochoa JF (2002) Técnicas de aspiração de tecido adiposo. In: Mélega JM (ed) Cirurgia plástica, fundamentos e arte: Princípios gerais. Medsi: Rio de Janeiro, pp.185–191
Silberg B (1998) The use of external ultrasound-assisted lipoplasty. Aesth Surg J 18:284–285
Carpaneda CA (1997) Inflammatory reaction and capsular contracture around silicone implants. Aesth Plast Surg 21:110–114
Gayou RM (1979) A histological comparison of contacted and noncontracted capsules around silicone breast implants. Plast Reconstr Surg 63:700–707
Thomsen JL, Chriestensen L, Nielsen M, et al. (1990) Histologic changes and silicone concentrations in human breast tissue surrounding silicone breast prostheses. Plast Reconstr Surg 85:38–41
Rubino C, Mazzarello V, Farace F, et al. (2001) Ultrastructural anatomy of contracted capsules around textured implants in augmented breasts. Ann Plast Surg 46:95–102
Wyatt LE, Sinow JD, Wollman JS, et al. (1998) The influence of time on human breast capsule histology: Smooth and texture silicone-surface implants. Plast Reconstr Surg 102:1922–1931
Wickman M, Johansson O, Olenius M, et al. (1993) A comparison of the capsules around smooth and textured silicone prostheses used for breast reconstruction: A light and electron microscopic study. Scand J Plast Reconstr Surg Hand Surg 27:15–22
Barone FE, Perry L, Keller T, et al. (1992) The biomechanical and histopathologic effects of surface texturing with silicone and poliurethane in tissue implantation and expansion. Plast Reconstr Surg 90:77–86
McLean AL, Talmor M, Harper, et al. (2002) Expression of cyclooxigenase-2 in the periprosthetic capsule surrounding a silicone shell implant in the rat. Ann Plast Surg 48:292–297
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mendes, F.H., Viterbo, F. & DeLucca, L. The Influence of External Ultrasound on the Histologic Architecture of the Organic Capsule Around Smooth Silicone Implants: Experimental Study in Rats. Aesth Plast Surg 32, 442–450 (2008). https://doi.org/10.1007/s00266-007-9063-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-007-9063-0