Silicone particles in capsules around breast implants: Establishment of a new pathological methodology to assess the number of particles around breast implants. 2023

M Dziubek, and R Laurent, and M Bonapace-Potvin, and L Gaboury, and M A Danino
Department of plastic and reconstructive surgery, University of Montreal Hospital Center (CHUM), 1000, rue Saint-Denis, Montreal, Quebec H2X 0C1, Canada.

BACKGROUND The presence of silicone particles in breast implant capsules has been observed since the 1970s. Since then, little data has been published regarding the amount of silicone that is susceptible to migrate into the capsule. Quantifying the amount of silicone migration from the implant to the capsule could inform on the level of silicone exposure a patient with breast implants may experience in the short- or long-term. The objective of this study is to present a histological quantification methodology of the number of silicone particles present in breast implant capsules. METHODS A prospective study was performed on capsule samples from patients requiring revision surgery. The slides were digitalized and analyzed with a viewer software. For each sample, we (1) manually counted each silicone particle, (2) measured the average particle size, (3) measured the capsule surface area, and (4) calculated the particle number density in each capsule sample. The average of all capsule samples' particle number densities was then compared to the total volume of the capsule to estimate the total number of silicone particles found within the capsule of each breast implant. RESULTS Six capsules from six different patients were analyzed. Two capsules were from saline implants while four capsules were from silicone implants. All four silicone implant capsules contained between 352,928 and 9,002,235 silicone particles. The particle number density ranged from 20.5 to 683.5 particles per mm3 of capsule. The two saline-filled implant capsules were free of silicone particles. The average of all capsule samples' particle number densities was then compared to the total volume of the capsule to estimate the total number of silicone particles found within the capsule of each breast implant. CONCLUSIONS We describe a new and reproducible methodology to quantify realistically the silicone particles in the periprosthetic capsule of breast implants.

UI MeSH Term Description Entries
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012828 Silicones A broad family of synthetic organosiloxane polymers containing a repeating silicon-oxygen backbone with organic side groups attached via carbon-silicon bonds. Depending on their structure, they are classified as liquids, gels, and elastomers. (From Merck Index, 12th ed) Silicone
D018427 Breast Implants Implants used to reconstruct and/or cosmetically enhance the female breast. They have an outer shell or envelope of silicone elastomer and are filled with either saline or silicone gel. The outer shell may be either smooth or textured. Breast Prosthesis, Internal,Implants, Breast,Breast Implant,Breast Prostheses, Internal,Implant, Breast,Internal Breast Prostheses,Internal Breast Prosthesis,Prostheses, Internal Breast,Prosthesis, Internal Breast
D019928 Breast Implantation Surgical insertion of an inert sac filled with silicone or other material to augment the female form cosmetically. Breast Prosthesis Implantation,Breast Implantations,Breast Prosthesis Implantations,Implantation, Breast,Implantation, Breast Prosthesis,Implantations, Breast,Implantations, Breast Prosthesis,Prosthesis Implantation, Breast,Prosthesis Implantations, Breast

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