[EFFECT OF INFECTION ON CAPSULE FORMATION AFTER BREAST IMPLANTS]

To investigate the correlation between infection and capsular contracture by observing the effect of infection on the formation of the surrounding capsule after breast implants.

Three healthy adult female Diannan small-ear pigs underwent augmentation mammaplasty using miniature implants, which were randomly divided into group A (12 nipples), group B (10 nipples), and group C (12 nipples). Staphylococcus epidermidis (SE ATCC12228 and SE RP62A, 1.2 x 10⁵ CFU/mL) was inoculated into the periprosthetics of groups B and C, and sterile PBS in group A before breast implants. Then the silica gel prosthesis was put, total 34 implants in 3 groups. After 13 weeks, the capsule was harvested to measure the capsular tension and weight. HE staining was used to observe the structure characteristics of the capsule and to measure the capsule thickness, Van-Gieson (VG) staining to observe the capsule collagen characteristics, and α-smooth muscle actin (α-SMA) immunocytochemistry staining to observe myofibroblasts in capsule.

Primary healing of incision was obtained, and 3 small-ear pigs showed stable life indication. The complete fibrous capsule was observed after 13 weeks in 3 groups. Capsule tension showed no significant difference among 3 groups (P > 0.05). Capsule weight was significantly greater in group C than in groups A and B (P < 0.05). HE staining showed that capsule structure of the 3 groups was similar with obvious dense layer and loose layer, and the capsule thickness was also significantly greater in group C than in groups A and B (P < 0.05), but no significant difference was found between groups A and B (P > 0.05). VG staining showed that collagenous fiber in the capsule were more compact in group C than in groups A and B. The α-SMA immunocytochemistry staining indicated the myofibroblasts in capsule were the most in group C.

Infection after breast implants has obvious impacts on the formation of the capsule, and there was a causal link between infection and capsular contracture.