Three Drugs, And Small Combination Prosthesis To Reduce Capsular Contracture Experimental Study And Clinical Applications

Capsular contracture remains the major complication of reconstructive and aesthetic breast surgery. To solve the problem, initial study related to the use of medical agents and the change of implant structure were performed. We proposed the use of a new way that a modified expander catheter to be mounted on gel implant seperatlly delivered the three chemical agents: triamcinolone acetonide, papaverine or hydrouridase which acted on capsular contracture. From the change of implant structure angle, We proposed a newmammaplasty-miniprostheses of mammaplasty, which was the use of a series of small 10ml silicone prosthesis (miniprostheses), to substitute for the conventional ones. We have studied for capsule of the miniprostheses. There were clinically 5 cases related to the miniprostheses in mammaplasty. The results were satisfied.一, The study of three medical agents on the depression of capsularcontractureObjective To study triamcinolone acetonide, papaverine and hydrouridase on the depression of capsular contracture.Methods 40 rabbits were individed into 4 groups of 10 animals each. Every 10ml silicone implants was implanted beneath the panniculus carnosus muscle of one rabbit. At the same time, a modified expander catheter was mounted on gel implant. This catheter had many lateral holes and distance was blind. One of the three substances, triamcinolone acetonide (10mg/3ml), papaverine (30mg/3ml) and hyaluronidase (200U/3ml), was infused through the expander pot and catheter as the experimental groups at 1,2,and 3 months; 3 ml saline was used as the control group at same time. At 6 months, measures related to contracture were physically and biochemically performed on anesthetized animals. Capsular histology examinations were also performed.Results1. Capsular firmness:(1) Baker scales: Baker scales of the control group (saline groups) were evidently higher than that of the three experiment groups (triamcinolone acetonide groups, papaverine groups and hyaluronidase groups) (p<0.01). Baker scales of the triamcinolone acetonide group was higher than that of the papaverine group and hyaluronidase group (p<0.05). The difference in Baker scales between papaverine group and hyaluronidase group was not statistically significant (p>0.05).(2) Implant compression: Implant compression of the control group (saline groups) was evidently lower than that of three experiment group (triamcinolone acetonide groups, papaverine groups and hyaluronidase groups) (p<0.01). Implant compression of the triamcinolone acetonide group was lower than that of the papaverine group and the hyaluronidase group(p<0.05). The difference in implant compression between the papaverine group and hyaluronidase group was not statistically significant(p>0.05);(3) Capsular incision width: Capsular incision width of the control group (saline group) was evidently wider than that of the three experiment groups (triamcinolone acetonide group, papaverine group and hyaluronidase group) (p<0.01). Capsular incision width of the triamcinolone acetonide groups was lower than that of the papaverine group and the hyaluronidase group(p<0.05). The difference in capsular incision width between papaverine group and hyaluronidase group was not statistically significant(p>0.05); (4)Capsular thickness: Capsular thickness of the control group (saline group) was evidently thicker than...