Copeland M, Choi M, Bleiweiss I J
Department of Surgery, Mount Sinai Medical Center, New York, N.Y.
Plast Reconstr Surg. 1994 Oct;94(5):628-33; discussion 634-6.
Saline-filled prostheses are currently the only type of prostheses available for cosmetic use in the United States because of concerns raised about the possibility of systemic toxicity of silicone-filled artificial mammary implants. Although the approved implants are saline-filled, their potential to release silicone particles from the shells has not been systematically evaluated. We performed microscopic examination of the pericapsular tissue of 54 patients with textured-surface implants and compared these with 51 patients with smooth-walled implants over a 2-year period. The capsules that had formed around virtually all textured-surface implants had silicone fragments present either in extracellular spaces, in vacuolated histiocytes, or in the form of foreign-body granulomas in surrounding fibroadipose tissue but not in capsules associated with smooth-walled implants. In 87 percent of samples of pericapsular tissue from textured saline implants, the contact surface displayed exuberant reactive synovial metaplasia, a histologic pattern not previously described with these devices. Our findings suggest that smooth-walled prostheses are associated with less silicone fragmentation than textured devices in the peri-implant tissue capsules that tend to form around artificial surfaces used for this purpose.
由于对硅胶填充人工乳房植入物可能产生全身毒性的担忧，目前在美国，盐水填充假体是唯一可用于美容用途的假体类型。尽管获批的植入物是盐水填充的，但其外壳释放硅胶颗粒的可能性尚未得到系统评估。我们对54例使用表面有纹理的植入物患者的包膜周围组织进行了显微镜检查，并在两年时间内将这些结果与51例使用光滑壁植入物的患者进行了比较。几乎所有表面有纹理的植入物周围形成的包膜中，硅胶碎片存在于细胞外间隙、空泡化组织细胞中，或以异物肉芽肿的形式存在于周围纤维脂肪组织中，但在与光滑壁植入物相关的包膜中则不存在。在有纹理的盐水植入物的包膜周围组织样本中，87%的接触表面显示出旺盛的反应性滑膜化生，这是一种此前未在这些装置中描述过的组织学模式。我们的研究结果表明，在用于此目的的人工表面周围倾向于形成的植入物周围组织包膜中，光滑壁假体比有纹理的假体产生的硅胶碎片更少。
