ArticleAesthetic plastic surgery2025
A Histological Assessment Tool for Breast Implant Capsules Validated in 480 Patients with and Without Capsular Contracture.
Article in Aesthetic plastic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Technique-Driven and Patient-Specific Variations in Complications of Mastectomy with Immediate Breast Reconstruction: An Evidence-Based Review.Journal of clinical medicine · 2026Review
- A proposal of a new periimplant breast pathology classification into 3 types.Scientific reports · 2026Article
- Foreign body reaction: towards a macrophage-centered adverse outcome pathway for fibrotic encapsulation.Frontiers in toxicology · 2026Article
- Histomorphologic Outcomes of GalaFLEX Scaffold Used in Breast Surgery: Clinical Follow-up From 6 Weeks to 63 Months.Aesthetic surgery journal · 2025Article
- Periostin mediates collagen production, ECM remodeling and myofibroblast differentiation in breast prosthesis capsule formation.Scientific reports · 2025Article
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Authors and funding
13 authors.
Funding
Abstract
backgroundUnderstanding the impact of breast implants on the histological response in the surrounding fibrous capsule is important; however, consensus is lacking on how to analyze implant capsules histologically. We aimed to develop a standardized histological assessment tool to be used in research potentially improving diagnostic accuracy and treatment strategies for capsular contracture.
methodsBiopsies of breast implant capsules from 480 patients who had undergone breast augmentation or reconstruction were collected and stained with hematoxylin and eosin. Initially, biopsies from 100 patients were analyzed to select histological parameters demonstrating the highest relevance and reproducibility. Then, biopsies from the remaining 380 patients were used to determine intra- and interobserver agreements of two blinded observers and agreement with a pathologist. Finally, we tested the association between the parameters and capsular contracture.
resultsThe histological assessment tool included ten parameters assessing the inflammatory, fibrotic, and foreign-body reaction to breast implants, each graded on two-, three-, or four-point scales. Intra- and interobserver agreements were almost perfect (0.83 and 0.80), and agreement with the pathologist was substantial (0.67). Four parameters were significantly correlated with capsular contracture, namely chronic inflammation with lymphocyte infiltration (p < 0.01), thickness of the collagen layer (p < 0.0001), fiber organization (p < 0.01), and calcification (p < 0.001).
conclusionsThis is the first validated histological assessment tool for breast implant capsules. The validated tool not only advances our understanding of capsular contracture but also sets a new standard for histological evaluation in breast implant research and clinical diagnostics. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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