Plastic Surgery Research Council
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CAPSULAR CONTRACTURE: ANGIOGENESIS AND ROLE OF ESTROGEN RECEPTOR IN PERIPROSTHETIC TISSUE REMODELING.
Presenter: Daniele Tosi, MD
Co-Authors: SEGRETO F; CAROTTI S; MARANGI G; MORINI S; PERSICHETTI P
UNIVERSITY CAMPUS BIOMEDICO OF ROME

Background: Capsule contracture is the most important complication of aesthetic and reconstructive breast surgery. The aim of the study was to investigate the role of estrogen receptor and angiogenesis in periprosthetic capsular tissue remodeling.

Methods: 32 peri-expander capsules were examined for estrogen receptors and and -SMA expression. Contracture severity was valuated with Baker s score. Specimens were stained with Hematoxylin and Eosin, Masson trichrome, immunohistochemistry and immunofluorescence for -Smooth Muscle Actin, Estrogen receptor-, Estrogen receptor , Collagen type I and type III, CD31 (as angiogenic marker) and evaluated at Transmission electron microscopy. A retrospective analysis of 263 cases of breast reconstruction was performed to evaluate the relationship between anti-estrogenic therapy and severity of capsule contracture.

Results: Myofibroblast, -SMA positive, expressed either ER- and ER- . In the whole sample ER- positively correlates with the tissue expression of collagen type I (P = 0.025) and with the expression of -SMA by myofibroblasts (P = 0.037). There was a correlation between CD31 positive vessels and the presence of collagen type I (P = 0.009). Angiogenesis also correlates with the degree of inflammatory infiltrate presents in the capsule (P= 0.006). Finally a very important clinical data observed concerns the reduction of risk of severe capsular contracture in patients taking anti-estrogen therapy (P


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