Plast Reconstr Surg. 1994 Oct;94(5):628-33; discussion 634-6.

Comment in: Plast Reconstr Surg. 1995 Aug;96(2):484-5. Plast Reconstr Surg. 1995 Dec;96(7):1747. Plast Reconstr Surg. 1996 Jan;97(1):249.

Silicone breakdown and capsular synovial metaplasia in textured-wall saline breast prostheses. 1994

Copeland M, Choi M, Bleiweiss IJ.

Department of Surgery, Mount Sinai Medical Center, New York, N.Y.

Saline-filled prostheses are currently the only type of prostheses available for cosmetic use in the United States because of concerns raised about the possibility of systemic toxicity of silicone-filled artificial mammary implants.

Although the approved implants are saline-filled, their potential to release silicone particles from the shells has not been systematically evaluated. We performed microscopic examination of the pericapsular tissue of 54 patients with textured-surface implants and compared these with 51 patients with smooth-walled implants over a 2-year period. The capsules that had formed around virtually all textured-surface implants had silicone fragments present either in extracellular spaces, in vacuolated histiocytes, or in the form of foreign-body granulomas in surrounding fibroadipose tissue but not in capsules associated with smooth-walled implants. In 87 percent of samples of pericapsular tissue from textured saline implants, the contact surface displayed exuberant reactive synovial metaplasia, a histologic pattern not previously described with these devices. Our findings suggest that smooth-walled prostheses are associated with less silicone fragmentation than textured devices in the peri-implant tissue capsules that tend to form around artificial surfaces used for this purpose.

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