ABSTRACT
In plastic reconstructive surgery, silicone rubber implants are used to maintain space for a secondary autologous graft or to augment soft tissue defects. The implanted silicone gel caused a classic foreign body reaction. The microchemical analyses are related to the distribution of silicone in the tissue. The electron microscope investigation of human and guinea pig material suggests that the particles found extracellulary in the capsule and intracellulary within the macrophages derive from the silicone prostheses. In augmentation-mammaplasties, when a permanent retromammary or subpectoral silicone polymer implant is used, this encapsulation, however, impairs the primary good results of the operation to a various degree, because the shrinkage of the "capsule" changes the shape, in all cases. This tissue reaction has been widely studied in humans as well as in laboratory animals by various investigators. The morphological substrate for active capsule shrinkage consists of myofibroblasts as demonstrated by several investigators. The significant morphological differences were related to the clinical features.
