Spherical contracture of the fibrous capsules around breast implants is one of major problems in augmentation mammaplasty using prosthesis During the past years several methods have been used to try to lessen the incidence of this complication. One of the procedures is the instillation of the non-water-soluble steroid, triamcinolone acetonide, into the pockets around the prostheses at the time of implantation. But the effect is still controversial.
The aim of this experiment is to study the effects of non-water-soluble steroid (triamcinolone acetonide) on the formation of fibrous capsule around breast prostheses.
After implantation of two miniature gel-filled mammary prostheses (2.5 cm diameter, Koken Corp., Tokyo, Japan) beneath the panniculus carnosus of the abdomen of each of thirty rabbits, 10 mg of triamcinolone acetonide was instilled around the prostheses in the steroid group, and 1.0 ml of saline solution in the control group. The compressibility of the mound, thickness and histological architecture of the fibrous capsule were observed 10, 20 and 90 days after the implantations.
The results were as follows:
1. In the steroid group, the degree and incidence of capsular contracture were significantly lower and the thickness of the capsule was thinner than in the control group.
2. The capsule and surrounding tissue showed less development in the steroid group than in the control group, and the collagen fiber was denser and more matured in the control group than in the steroid group.
3. Reticular fiber was found only in the 10 days groups and elastic fiber was not found in either of the two groups.
Based on these observations, it seems that periprosthetic instillation of steroid has an effect to reduce the incidence and degree of capsular contracture by decreasing the density of the collagen fibers and changing their arrangement.
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