Inflammatory reaction and capsular contracture around smooth silicone implants

Histologic studies were performed on capsular tissue resected from 21 patients who were implanted with smooth silicone prostheses filled with gel. The results disclosed a nonuniform response to the implants. The granulomatous reaction to the silicone showed important variations along the same surface of the implants, between the plane and the concave surfaces, between equivalent points at the right and left sides, and among the patients. Also, a significant difference was observed between reactions and capsules in early and late stages. The author believes these variations of the capsular inflammatory reaction promote different sites of contraction between cell-to-cell, or cell-to-collagen-to-cell. These adding forces result in vectors of different intensities and directions around the implants which explains the various clinical grades of capsular contracture.