The Effects of Vascular Endothelial Growth Factor on Capsule Formation around Silicone Implant in Rats

Silicone breast implants have been used for breast augmentation and reconstructive surgery for the past 40 years. Capsular contracture is a relatively common complication (a capsule that forms around the breast implant, thereby causing a deformity and pain), and poses challenging problems for surgeons [1]. Clinically, patients with severe capsular contracture, such as those with capsular contracture grade III or IV (Baker’s classification), experience pain or tenderness, which may eventually lead to poor functional and aesthetic outcomes [2]. Severe capsular contractures have been corrected by capsulotomy or capsulectomy; other treatment methods are to change the location of the breast implants or replace them with other products that have a different surface property [3,4]. There are no established methods to prevent the occurrence of capsular contracture. The exact pathophysiology of capsular contracture remains unclear, but previous studies have suggested that it is associated with chronic inflammatory factors, such as a foreign body reaction to the implant, the surface property of the implant, site of implant placement, postoperative bacterial infections, hematoma, or seroma [5,6]. Studies have examined whether inhibiting inflammatory events that cause a fibrosis is effective in preventing the capsular contracture, demonstrating that anti-inflammatory agents (e.g., calcium channel blockers), angiotensin-converting enzyme inhibitors, and leukotriene receptor antagonists (e.g., zafirlukast and montelukast) were effective in reducing the degree of capsular contracture [7-11]. Studies have reported, however, that ischemic changes may lead Da Han Kim, You Seong Song, Seung Yong Song, Chung Hun Kim