title: How texture-inducing contraction vectors affect the fibrous capsule shrinkage around breasts implants?
abstract: BACKGROUND
  Breast augmentation was performed on nine female volunteer patients to determine the influence of three textured surfaces on fibrous capsule formation. The high degree of surface texture reduced the capsular fibrous tissue formation.
  
  
  METHODS
  Patients were distributed according to the degree of texture created by the open-pore diameter and depth of the surface texture. Macroscopic and histological examinations were performed to evaluate the implant texture and fibrous capsule interface. Magnetic resonance imaging established a mutual correlation with breast firmness achieved by the Baker grade.
  
  
  RESULTS
  The parallelogram law was applied to linear vectors arising from the same initial point into the concavities or undulations on the textured surface to achieve the resultant contraction vector. They were identical to resultant vectors created on the fibrous capsule except in the inverted direction. The adhesive effect or mirror-image tissue response to the implant texture on the fibrous capsule noticeably reduced capsular contracture but only with macrotextured implants. Increased capsular contracture resulted from implants showing micro- and medium surface texture with no significant difference between them.
  
  
  CONCLUSIONS
  Biocell™ implants created resultant vectors on the capsular interface of small and similar lengths with divergent directions creating natural breast firmness. Biodegradation of Polyurethane™ foam disrupted the texture from creating resultant vectors of long and different lengths and in variable directions, increasing breast firmness from 12 months. Siltex™ implants created few and very long resultant vectors perpendicular to the fibrous capsule that developed fibrous capsule contraction after 9 months. We conclude that implants with macrotextured surfaces significantly reduced the risk of fibrous capsular contraction.
authors.affiliation: ACA-Institute of Assistance in Plastic Surgery of São Paulo, General Hospital São Luiz, Rua Afonso de Freitas, 641, São Paulo, SP, 04006-052, Brazil. acabramo@abramo.com.br
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Abramo
authors.forename: Valeria Ribeiro
authors.initials: VR
authors.lastname: De Oliveira
authors.forename: Miguel Cirilo
authors.initials: MC
authors.lastname: Ledo-Silva
authors.forename: Erick Leonardo
authors.initials: EL
authors.lastname: De Oliveira
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D018427:Breast Implants / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D005355:Fibrosis; D006801:Humans; D057910:Implant Capsular Contracture / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D016462:Mammaplasty / Q000009:adverse effects*; D008875:Middle Aged