Degenerative mineralization in the fibrous capsule of silicone breast implants

Abstract

The formation of a fibrous capsule made of long collagen fibers surrounding breast implants represents an unavoidable phenomenon as the patient's reaction to the presence of a foreign body. Depending upon the size and shape of the implants and the chemicals percolating through the shell, this fibrous capsule is continuously remodeled. The compaction of the foreign debris in the vicinity of the silicone shell is followed by the loss of cellular activity, shrinkage and necrosis. Calcification is the ultimate step. These phenomena were illustrated in the analysis of 18 explanted breast prostheses after 20 or more years of implantation. The degenerative mineralization was shown in scanning electron microscopy and light microscopy. The minerals proved to be bone-like hydroxyapatite by X-ray diffraction and Solid State NMR analysis. Whatever the characteristics of any sophisticated new model of breast implant, phenomenon of mineralization might be minimized but it is very unlikely that it would be totally eliminated.