백서에서 유방삽입물 주위피막에 영향을 미치는 여러가지 인자에 관한 실험적 연구 = An Experimental Study of the Effect of the Multiple Factors on the Capsules around Miniature Breast Implants in Rats

다국어 초록 (Multilingual Abstract)

It is well known that fibrous capsules can contract around the breast implants resulting in a firm, distorted configuration compromising the desired result of augmentation mammaplasty. Two prominent theoties to explain the capsular contracture arise from the contractability of myofibroblast and the reorganization of collagen fibers.
Clinically, many etiologoes such as hematoma, infection, small prothrsis pocket and foreign bodies are suspected as the causative factors and many preventive maneuvers such as steroid instillation, massage, vitamin and collagen coating on the surface of the silastic implant are tried to prevent capsular contractures after augmentation mammaplasty. But, no definitive causative factors or preventive maneuvers are confirmed.
In order to investigate the effect of the multiple factors on the capsules around the breast implants, a miniature silicone implant was inserted under the panniculus carnosus of rat.
Author made multiple conditions such as infection, talcum powder, steroid instillation and vitamin E groups and examined the breast firmness and the histopathological changes of capsules with light microscope, transmission & scanning microscope after 1 week, 2 weeks, 1month, and 3 months. For the study of the collagen fiber type, immunocytochemical study was performed.
The results were as follows
1. The major cause of the capsular contracture around the breast implants was the reoranization of collagen fibers rather than the contractability of myofibroblasts.
2. In the immunocytochemical study, the predominant collagen type of the capsule in the early stage was type Ⅲ, bur after 1 month, it was converted to type Ⅰ.
3. In the infection and talcum powder group, the incidence of capsular contracture was increased. Histopathologically, the inflammation was prominent in the early stage and collagen fibers revealed thick, irregular and compact structures in the late stage.
4. In the steroid group, the incidence of capsular contracture was decreased. HIstopathologically, the collagen bundles were well arranged with parallel pattem by very fine fibers and wide spaces between fibers.
5. In the vitamin E group, there was no significant finding.
The above results suggest that the major cause of capsular contracture is the reorganization of collagen fibers and the infection & talcum powder caneasily induce capsular contracture, but, the steroid instillation can effectively prevent it after augmentation marmmoplasty.