[Pathomorphology and indications in plastic surgery of the breast]

The pathohistological features of two breasts with implants coated with polyurethane are described.--The first case with an implant of 4 months shows a capsule with cellular collagen tissue and triangular and rectangular polyurethane particles with foreign body reactions. The second case, an autopsy of a female artist, revealed a mammary augmentation in both breasts in situ. The prothesis were surrounded by a regular capsule tissue without inflammation.--The different reactions in the connective tissue of the breasts surrounding the implants are described: Silicone implants by Cronin and polyurethane coated implants by Ashley. Complications of breast prothesis are discussed. The constrictive fibrosis is initiated by local chronic inflammation and foreign body reactions. The subcutaneous mastectomy with implantation of prothesis is performed today in cases of fibrocystic diseases with atypical epithelial proliferations, in cases with recurrend fibrocystic disease, with non-invasive ductal carcinoma and lobular carcinoma in situ. The subcutaneous mastectomy is therefore a prophylactic and a therapeutic method.