As anyone with gel silicone implants knows, capsular contracture is a risk. I throw the kitchen sink at trying to avoid it. I avidly follow all the journals and go to my meetings to find little tidbits to help.
This is a study out of Austria, looking at the body’s immune response to the silicone implant. Does this lead to capsular contracture?
Study was with silicone breast implants. It appears in the Plastic and Reconstructive Surgery Journal from February 2012. The title (get ready- it is a science one) is “T Regulatory Cells and TH17 Cells in Perisilicone Implant Capsular Fibrosis.” (whew! this is real bench research.)
They studied the immune response by the lymphocytes in the tissue. They looked at immune response activation by phenotype and function of the lymphocytes in the tissue. (They looked at T regulatory cells, cytokines, and T cell receptors). They also looked at T regulatory cells in the capsule around the implant itself.
Findings?
- Silicone implants trigger a specific, antigen driven local immune response
- This is through activated TH1/TH17 cells
- This suggests the fibrosis of the capsule is assisted by the production of profibrotic cytokines, which happen because the local T cells don’t function appropriately.
What does this mean?
Capsular contracture is the Achille’s heel of breast implant reconstruction. It is likely the most common reason I see women who want to revise their implants. If there is a way to prevent or minimize this hardening (which can lead to implant malposition, firmness of the breast, pain, asymmetry, or other issues), we want to minimize it.