SMOOTH VERSUS TEXTURED EXPANDER IMPLANTS - A DOUBLE-BLIND-STUDY OF CAPSULE QUALITY AND DISCOMFORT IN SIMULTANEOUS BILATERAL BREAST RECONSTRUCTION PATIENTS

Textured silicone expanders are alleged to be less painful in the fill ing process, to have less capsular contracture, and to stay in positio n better than smooth silicone expanders. To test these three hypothese s, 6 patients undergoing bilateral simultaneous expander implant place ment for breast reconstruction after mastectomy were studied. In a dou ble-blind fashion, after smooth and textured implant placement (one in each side) and initial wound healing, each patient was sequentially e xpanded with equal volumes of saline. In each patient, at each expansi on, pressure data, discomfort scores, and implant placement measuremen ts were made. At implant removal, smooth and textured capsule tissues were studied for collagen type content and ability to contract the pat ient's own fibroblast-populated collagen lattice. In 4 of 6 patients t he smooth expander was associated with lower injection pressures and l ess discomfort. In all patients the expanders maintained their positio n, except in I patient whose smooth implant shifted laterally. The cap sular collagen typing and fibroblast-populated collagen lattice studie s demonstrated no difference between smooth and textured capsules. In this double-blind clinical study in simultaneous bilateral breast reco nstruction patients we could not confirm the suggestion that textured silicone expanders produce less capsular contracture and cause less pa in with injection.