PATHOLOGICAL AND BIOPHYSICAL FINDINGS ASSOCIATED WITH SILICONE BREASTIMPLANTS - A STUDY OF CAPSULAR TISSUES FROM 86 CASES

Breast implant capsular tissues from 86 cases were studied to characte rize the relationship between capsular findings and the type of implan t used. Tissues were examined hy light microscopy, immunohistochemistr y, scanning electron microscopy/energy dispersive x-ray anal! sis and Fourier transform infrared, and Raman microspectroscopy. Capsular path ology was influenced br tile structure and composition of tile implant . A pseudoepithelium at the inner capsular surface (synovial metaplasi a) was noted with silicone gel-filled, saline-filled, and polyurethane -coated implants. and disproportionately with textured surface implant s. Immunohistochemical studies of pseudoepithelium supported a macroph age/histiocyte cellular origin. Talc was identified intracellular with in macrophages in 42 cases. Capsular calcification was strongly associ ated with the presence of implant stabilization patch material. Infrar ed spectra were used io identify silicone, talc? Dacron, and two diffe rent types of polyurethane in capsular tissues. Micropapillary structu res identified at the pseudoepithelial surface have, to the authors kn owledge, not been previously described.