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Silicone Implants with Smooth Surfaces Induce Thinner but Denser Fibrotic Capsules Compared to Those with Textured Surfaces in a Rodent Model.

Fischer S, Hirche C, Reichenberger MA, Kiefer J, Diehm Y, Mukundan S, Alhefzi M, Bueno EM, Kneser U, Pomahac B - PLoS ONE (2015)

Bottom Line: However, this difference did not persist on day 120 (p=0.56).Thickness measurements were substantiated by MRI analysis and volumes changed accordingly.Significant differences in the expression of other genes were not observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America; Department of Hand-, Plastic and Reconstructive Surgery, BG Clinic Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.

ABSTRACT

Purpose: Capsular contracture is the most frequent long-term complication after implant-based breast reconstruction or augmentation. The aim of this study was to evaluate the impact of implant surface properties on fibrotic capsule formation in an animal model.

Materials and methods: Twenty-four rats received 1 scaled down silicone implant each; 12 of the rats received implants with textured surfaces, and the other 12 received implants with smooth surfaces. After 60 and 120 days, rats in each group underwent 7-Tesla Magnetic Resonance Imaging (MRI) and high-resolution ultrasound (HR-US), and specimens of the capsules were acquired and used to measure capsule thickness through histology, collagen density through picro sirius red staining, and analyses of expression of pro-fibrotic and inflammatory genes (Collagen1-4, TGFb1, TGFb3, Smad3, IL4, IL10, IL13, CD68) through qRT-PCR. Furthermore, MRI data were processed to obtain capsule volume and implant surface area.

Results: On day 60, histology and HR-US showed that fibrotic capsules were significantly thicker in the textured implant group with respect to the smooth implant group (p<0.05). However, this difference did not persist on day 120 (p=0.56). Capsule thickness decreased significantly over the study period in both smooth and textured implant groups (p<0.05). Thickness measurements were substantiated by MRI analysis and volumes changed accordingly. Implant surface area did not vary between study dates, but it was different between implant types. On day 60, the density of collagen in the fibrotic capsules was significantly lower in the textured implant group with respect to the smooth group (p<0.05), but again this difference did not persist on day 120 (p=0.67). Collagen 1 and CD68 were respectively over- and under expressed in the textured implant group on day 60. Significant differences in the expression of other genes were not observed.

Conclusion: Silicone implants with textured surfaces led to temporarily thicker but less dense fibrotic capsules compared with smooth surfaces. 7-Tesla MRI and HR-US are capable for non-invasive in-vivo assessment of capsular fibrosis in an animal model and can provide unique insights into the fibrotic process by 3D reconstruction and surface area measurement.

No MeSH data available.


Related in: MedlinePlus

Results of quantitative real time PCR for CD68 given in fold change compared to textured implant group of day 60 or 120, respectively.Asterisks and brackets indicate statistical significance and P<0.05 was considered statistically significant.
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pone.0132131.g015: Results of quantitative real time PCR for CD68 given in fold change compared to textured implant group of day 60 or 120, respectively.Asterisks and brackets indicate statistical significance and P<0.05 was considered statistically significant.

Mentions: Collagen 1 was significantly over expressed in the textured implant group on day 60 compared with both smooth implant groups on days 60 and 120 (RQ day 60 smooth vs. day 60 textured: 0.11±1.04, p<0.05; RQ day 120 smooth vs. day 60 textured: 0.16±0.95, p<0.05). Significant differences in the expression of collagen types 2, 3 and 4 were not detected among study groups. However, Collagen 2 trended towards highest expression in the smooth implant group on day 60 and decreased over the study period, that is, from day 60 to day 120 (Fig 14). In general, collagen subtypes appeared to be expressed less in smooth implant groups. With respect to inflammatory markers, significant differences were only detected for CD68; namely, there was lower expression in the smooth implant group on day 120 compared with the textured implant group on day 60 (RQ day 60 textured vs. day 120 smooth: 1.96±0.17; p<0.05) (Fig 15). Significant differences among study groups were not detected in any of the other investigated genes. Of note, inflammatory marker IL 10 was only present in the textured implant group on day 60 and not detectable anymore on day 120. In contrast, the expression of fibrotic markers, namely TGFbeta3 and 1, as well as Smad3 remained stable over the study period and unrelated to the implant type. Results are given in Fig 16 as heat map with increasing positive or negative delta CT values in brighter green or red colors, respectively. Black indicates that either the gene is not expressed or is below the limit of detection.


Silicone Implants with Smooth Surfaces Induce Thinner but Denser Fibrotic Capsules Compared to Those with Textured Surfaces in a Rodent Model.

Fischer S, Hirche C, Reichenberger MA, Kiefer J, Diehm Y, Mukundan S, Alhefzi M, Bueno EM, Kneser U, Pomahac B - PLoS ONE (2015)

Results of quantitative real time PCR for CD68 given in fold change compared to textured implant group of day 60 or 120, respectively.Asterisks and brackets indicate statistical significance and P<0.05 was considered statistically significant.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4495016&req=5

pone.0132131.g015: Results of quantitative real time PCR for CD68 given in fold change compared to textured implant group of day 60 or 120, respectively.Asterisks and brackets indicate statistical significance and P<0.05 was considered statistically significant.
Mentions: Collagen 1 was significantly over expressed in the textured implant group on day 60 compared with both smooth implant groups on days 60 and 120 (RQ day 60 smooth vs. day 60 textured: 0.11±1.04, p<0.05; RQ day 120 smooth vs. day 60 textured: 0.16±0.95, p<0.05). Significant differences in the expression of collagen types 2, 3 and 4 were not detected among study groups. However, Collagen 2 trended towards highest expression in the smooth implant group on day 60 and decreased over the study period, that is, from day 60 to day 120 (Fig 14). In general, collagen subtypes appeared to be expressed less in smooth implant groups. With respect to inflammatory markers, significant differences were only detected for CD68; namely, there was lower expression in the smooth implant group on day 120 compared with the textured implant group on day 60 (RQ day 60 textured vs. day 120 smooth: 1.96±0.17; p<0.05) (Fig 15). Significant differences among study groups were not detected in any of the other investigated genes. Of note, inflammatory marker IL 10 was only present in the textured implant group on day 60 and not detectable anymore on day 120. In contrast, the expression of fibrotic markers, namely TGFbeta3 and 1, as well as Smad3 remained stable over the study period and unrelated to the implant type. Results are given in Fig 16 as heat map with increasing positive or negative delta CT values in brighter green or red colors, respectively. Black indicates that either the gene is not expressed or is below the limit of detection.

Bottom Line: However, this difference did not persist on day 120 (p=0.56).Thickness measurements were substantiated by MRI analysis and volumes changed accordingly.Significant differences in the expression of other genes were not observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America; Department of Hand-, Plastic and Reconstructive Surgery, BG Clinic Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.

ABSTRACT

Purpose: Capsular contracture is the most frequent long-term complication after implant-based breast reconstruction or augmentation. The aim of this study was to evaluate the impact of implant surface properties on fibrotic capsule formation in an animal model.

Materials and methods: Twenty-four rats received 1 scaled down silicone implant each; 12 of the rats received implants with textured surfaces, and the other 12 received implants with smooth surfaces. After 60 and 120 days, rats in each group underwent 7-Tesla Magnetic Resonance Imaging (MRI) and high-resolution ultrasound (HR-US), and specimens of the capsules were acquired and used to measure capsule thickness through histology, collagen density through picro sirius red staining, and analyses of expression of pro-fibrotic and inflammatory genes (Collagen1-4, TGFb1, TGFb3, Smad3, IL4, IL10, IL13, CD68) through qRT-PCR. Furthermore, MRI data were processed to obtain capsule volume and implant surface area.

Results: On day 60, histology and HR-US showed that fibrotic capsules were significantly thicker in the textured implant group with respect to the smooth implant group (p<0.05). However, this difference did not persist on day 120 (p=0.56). Capsule thickness decreased significantly over the study period in both smooth and textured implant groups (p<0.05). Thickness measurements were substantiated by MRI analysis and volumes changed accordingly. Implant surface area did not vary between study dates, but it was different between implant types. On day 60, the density of collagen in the fibrotic capsules was significantly lower in the textured implant group with respect to the smooth group (p<0.05), but again this difference did not persist on day 120 (p=0.67). Collagen 1 and CD68 were respectively over- and under expressed in the textured implant group on day 60. Significant differences in the expression of other genes were not observed.

Conclusion: Silicone implants with textured surfaces led to temporarily thicker but less dense fibrotic capsules compared with smooth surfaces. 7-Tesla MRI and HR-US are capable for non-invasive in-vivo assessment of capsular fibrosis in an animal model and can provide unique insights into the fibrotic process by 3D reconstruction and surface area measurement.

No MeSH data available.


Related in: MedlinePlus