Characterization of the Capsule Surrounding Smooth and Textured Tissue Expanders and Correlation with Contracture

Erika Kuriyama, MD; Hiroko Ochiai, MD, PhD; Yoshikazu Inoue, MD, PhD; Yoshiaki Sakamoto, MD, PhD; Naoki Yamamoto, CMDT, PhD; Toshiaki Utsumi, MD, PhD; Kazuo Kishi, MD, PhD; Takayuki Okumoto, MD, PhD; Akihiro Matsuura, MD, PhD

doi:10.1097/GOX.0000000000001403

Plastic and Reconstructive Surgery, Global Open (Jul 2017)

Characterization of the Capsule Surrounding Smooth and Textured Tissue Expanders and Correlation with Contracture

Erika Kuriyama, MD,
Hiroko Ochiai, MD, PhD,
Yoshikazu Inoue, MD, PhD,
Yoshiaki Sakamoto, MD, PhD,
Naoki Yamamoto, CMDT, PhD,
Toshiaki Utsumi, MD, PhD,
Kazuo Kishi, MD, PhD,
Takayuki Okumoto, MD, PhD,
Akihiro Matsuura, MD, PhD

Affiliations

Erika Kuriyama, MD: From the *Department of Plastic and Reconstructive Surgery, Fujita Health University, Aichi, Japan; †Department of Plastic and Reconstructive Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; ‡Department of Plastic and Reconstructive Surgery, Keio University Hospital, Tokyo, Japan; §Laboratory of Molecular Biology, Institute of Joint Research, Fujita Health University, Aichi, Japan; ¶Department of Breast Surgery, Fujita Health University, Aichi, Japan; and ‖Department of Molecular Pathology, Fujita Health University Graduate School of Medicine, Aichi, Japan.
Hiroko Ochiai, MD, PhD: From the *Department of Plastic and Reconstructive Surgery, Fujita Health University, Aichi, Japan; †Department of Plastic and Reconstructive Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; ‡Department of Plastic and Reconstructive Surgery, Keio University Hospital, Tokyo, Japan; §Laboratory of Molecular Biology, Institute of Joint Research, Fujita Health University, Aichi, Japan; ¶Department of Breast Surgery, Fujita Health University, Aichi, Japan; and ‖Department of Molecular Pathology, Fujita Health University Graduate School of Medicine, Aichi, Japan.
Yoshikazu Inoue, MD, PhD: From the *Department of Plastic and Reconstructive Surgery, Fujita Health University, Aichi, Japan; †Department of Plastic and Reconstructive Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; ‡Department of Plastic and Reconstructive Surgery, Keio University Hospital, Tokyo, Japan; §Laboratory of Molecular Biology, Institute of Joint Research, Fujita Health University, Aichi, Japan; ¶Department of Breast Surgery, Fujita Health University, Aichi, Japan; and ‖Department of Molecular Pathology, Fujita Health University Graduate School of Medicine, Aichi, Japan.
Yoshiaki Sakamoto, MD, PhD: From the *Department of Plastic and Reconstructive Surgery, Fujita Health University, Aichi, Japan; †Department of Plastic and Reconstructive Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; ‡Department of Plastic and Reconstructive Surgery, Keio University Hospital, Tokyo, Japan; §Laboratory of Molecular Biology, Institute of Joint Research, Fujita Health University, Aichi, Japan; ¶Department of Breast Surgery, Fujita Health University, Aichi, Japan; and ‖Department of Molecular Pathology, Fujita Health University Graduate School of Medicine, Aichi, Japan.
Naoki Yamamoto, CMDT, PhD: From the *Department of Plastic and Reconstructive Surgery, Fujita Health University, Aichi, Japan; †Department of Plastic and Reconstructive Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; ‡Department of Plastic and Reconstructive Surgery, Keio University Hospital, Tokyo, Japan; §Laboratory of Molecular Biology, Institute of Joint Research, Fujita Health University, Aichi, Japan; ¶Department of Breast Surgery, Fujita Health University, Aichi, Japan; and ‖Department of Molecular Pathology, Fujita Health University Graduate School of Medicine, Aichi, Japan.
Toshiaki Utsumi, MD, PhD: From the *Department of Plastic and Reconstructive Surgery, Fujita Health University, Aichi, Japan; †Department of Plastic and Reconstructive Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; ‡Department of Plastic and Reconstructive Surgery, Keio University Hospital, Tokyo, Japan; §Laboratory of Molecular Biology, Institute of Joint Research, Fujita Health University, Aichi, Japan; ¶Department of Breast Surgery, Fujita Health University, Aichi, Japan; and ‖Department of Molecular Pathology, Fujita Health University Graduate School of Medicine, Aichi, Japan.
Kazuo Kishi, MD, PhD: From the *Department of Plastic and Reconstructive Surgery, Fujita Health University, Aichi, Japan; †Department of Plastic and Reconstructive Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; ‡Department of Plastic and Reconstructive Surgery, Keio University Hospital, Tokyo, Japan; §Laboratory of Molecular Biology, Institute of Joint Research, Fujita Health University, Aichi, Japan; ¶Department of Breast Surgery, Fujita Health University, Aichi, Japan; and ‖Department of Molecular Pathology, Fujita Health University Graduate School of Medicine, Aichi, Japan.
Takayuki Okumoto, MD, PhD: From the *Department of Plastic and Reconstructive Surgery, Fujita Health University, Aichi, Japan; †Department of Plastic and Reconstructive Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; ‡Department of Plastic and Reconstructive Surgery, Keio University Hospital, Tokyo, Japan; §Laboratory of Molecular Biology, Institute of Joint Research, Fujita Health University, Aichi, Japan; ¶Department of Breast Surgery, Fujita Health University, Aichi, Japan; and ‖Department of Molecular Pathology, Fujita Health University Graduate School of Medicine, Aichi, Japan.
Akihiro Matsuura, MD, PhD: From the *Department of Plastic and Reconstructive Surgery, Fujita Health University, Aichi, Japan; †Department of Plastic and Reconstructive Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; ‡Department of Plastic and Reconstructive Surgery, Keio University Hospital, Tokyo, Japan; §Laboratory of Molecular Biology, Institute of Joint Research, Fujita Health University, Aichi, Japan; ¶Department of Breast Surgery, Fujita Health University, Aichi, Japan; and ‖Department of Molecular Pathology, Fujita Health University Graduate School of Medicine, Aichi, Japan.

DOI: https://doi.org/10.1097/GOX.0000000000001403
Journal volume & issue: Vol. 5, no. 7

Abstract

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Background:. Capsular contracture is a common complication after breast augmentation surgery. This study pathologically evaluated the soft-tissue response to surface modifications in both smooth and textured tissue expander prostheses. Methods:. Smooth tissue expanders and textured tissue expanders in 5 cases each were used for breast reconstruction after mastectomy. Histological samples were harvested from the capsules when the tissue expanders were replaced by silicone implants. Collagen orientation and cellular responses were assessed histologically. Capsular contracture was evaluated using the Baker classification 6 months and 2 years after the removal of the tissue expander. Results:. The capsules surrounding the smooth tissue expanders tended to produce more contracture than those surrounding the textured tissue expanders. The collagen architecture of the capsules of the smooth tissue expanders showed random orientation with fragmentation. Conversely, the capsules of the textured tissue expanders showed parallel orientation with collagen bundles of almost normal structure. Significantly more fibrils of elastin and myofibroblasts were found in the capsules surrounding the smooth tissue than in those surrounding the textured ones. Conclusions:. The collagen fibers surrounding the smooth tissue expanders could be cracked during expansion, which may lead to scarring and contracture. Conversely, the collagen orientation surrounding the textured tissue expanders was excellent. Moreover, the increase in elastic fibers and myofibroblasts in the capsules surrounding the smooth tissue expanders may be associated with in vivo contraction patterns. Therefore, the surface type of tissue expanders affects capsular contraction after replacement with definitive implants.

Published in Plastic and Reconstructive Surgery, Global Open

ISSN: 2169-7574 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://www.prsgo.com

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