Comparative clinical evaluation of breast augmentation using silicone foam coated implants and textured implants

Purpose To evaluate whether silicone foam implants have a different evolution pattern compared to conventional texture implants. Methods Fifty-eight female patients underwent surgery. They were divided into two groups (silicone foam Lifesil® and microtexturized silicone Lifesil®). The evolution was analyzed in postoperative consultations, with physical examination, photographic documentation and filling in a satisfaction questionnaire, in the postoperative period of one month, four months, one year and then annually, up to a maximum of 3 years of follow-up. Results There were no statistically significant differences in presence of rippling, stretch marks, breast ptosis, capsular contracture and quality of scars. There was a higher rate of patients who were very satisfied with the outcome 360 days after surgery in the group receiving silicone foam implants (p = 0.036). Conclusion In short time, silicone foam envelope implants proved to be as reliable as textured silicone envelope implants, making them an option for augmentation mammoplasty.(AU)

Healing reaction to mammary prostheses covered by textured silicone and silicone foam in rats / Reação capsular aos revestimentos de próteses mamárias de silicone texturizado e espuma de silicone em ratos

PURPOSE: To compare the capsular reaction to two different coverings of silicone prosthesis through the biophysical characteristic of adherence and microscopical aspects of the inflammatory reaction and collagen formation. METHODS: Thirty two Wistar rats were used. In the dorsum of each animal a silicone elastomer with a smooth superficies and another coated with texturized silicone (Mentor) was implanted. Another one, with the same smooth superficies and other coated with silicone foam (Lifesil), making up in each side, of the dorsum, the texturized and silicone foam group respectively. The animals were split into four groups to be evaluated at 7, 14, 30 and 60 days. On the evaluation dates the implant adherence was verified witch a tensiometer and the values in kgf were obtained. The material was sent to histological analysis with hematoxilin-eosin and picrosirius colorations, to evaluate the inflammatory reaction and collagen synthesis, respectively. The obtained data were submitted to statistical treatment. RESULTS: There was more adherence of the tissue to the silicone foam (P<0,001). The inflammatory reaction was more intense in the same group, but without statistical significance. The number of giant cells and granulomas were more frequent in the silicone foam group. There was statistical significance at the 60 days for granulomas (P<0,028) and for all subgroups about number of giant cells (P< 0,012 to P<0,036). The thickness of the capsule in the silicone foam group was bigger, with statistical significance at seven days (P<0,028) and 60 days (P<0,012). The collagen deposition showed no difference in statistical analysis. CONCLUSION: The capsular reaction to the silicone foam showed stronger adherence, bigger thickness and had more number of granulomas and giant cells. No difference was observed in the intensity of inflammatory reaction in relation to type I and III collagen, when compared to the texturized cover.(AU)

OBJETIVO: Comparar a reação capsular de dois revestimentos de próteses de silicone através da característica biofísica de aderência e dos aspectos microscópicos de reação inflamatória e formação de colágeno. MÉTODOS: Implantaram-se no dorso de 32 ratos duas membranas de silicone ambas possuindo uma superfície lisa e outra diferindo em sua estrutura. Estes revestimentos foram de espuma de silicone (LifeSil) ou silicone texturizado (Mentor). Os dois grupos foram divididos em quatro sub-grupos conforme o tempo de pós-operatório avaliado: 7, 14, 30 e 60 dias. Obteve-se material para análise biofísica de aderência, a qual foi realizada com tensiômetro para obtenção de valores em kgf. O estudo microscópico da reação inflamatória e síntese de colágeno foi realizado com colorações de hematoxilina-eosina e picrosirius. Os dados foram submetidos a testes para avaliação da significância estatística. RESULTADOS: Houve maior aderência do revestimento de espuma de silicone ao tecido capsular, sendo este valor estatisticamente significativo (P<0,001). Quanto à reação inflamatória observou-se maior intensidade também neste grupo, porém sem significância estatística. Na contagem de células gigantes e granulomas os valores foram maiores para o grupo espuma de silicone com significância estatística no sub-grupo 60 dias (P<0,028) para número de granulomas; e em todos os sub-grupos (variando de P<0,012 a P<0,036) para o número de células gigantes. A reação capsular à espuma de silicone foi mais espessa, com significância estatística nos sub-grupos sete dias (P<0,028) e 60 dias (P<0,012). No estudo da síntese de colágeno, as diferenças não foram significantes estatisticamente. CONCLUSÃO: A reação capsular ao revestimento de espuma de silicone apresentou características de ter maior aderência ao tecido peri-implante, ser mais espesso, possuir maior número de granulomas e células gigantes de corpo estranho. Não demonstrou diferença quanto à intensidade da reação ...(AU)