The foreign body reaction begins as wound healing, including accumulation of exudate at the site of injury, infiltration of inflammatory cells to debride the area, and the formation of granulation tissue. However, the persistent presence of a breast implant, splinter, particulates, inhibits full healing. Rather than the resorption and reconstruction that occurs in wound healing, the foreign body reaction is characterized by the formation of foreign body giant cells, encapsulation of the foreign object, and chronic inflammation.

Foreign Body Giant Cells

Foreign body giant cells are the products of macrophage fusion, and are a hallmark of the foreign body reaction. When macrophages encounter a foreign object too large to be phagocytosed, such as an implant, it is thought that the macrophages experience “frustrated phagocytosis.” They fuse to form larger foreign body giant cells composed of up to a few dozen individual macrophages. Giant cells secrete degradative agents such as superoxides and free radicals, causing localized damage to implants and other foreign bodies. Currently, little is known of the role of foreign body giant cells. It is hard to say whether they are “more or less inflammatory” than a collection of macrophages. Macrophages and foreign body giant cells tend to remain at the surface of an implant for the duration of its residence.

Encapsulation refers to the firm, generally a vascular collagen shell deposited around a foreign body, effectively isolating it from the host tissues. This response was developed as a protective measure. Encapsulation is especially problematic for devices designed to interact with the body, such as glucose sensors. The foreign body reaction can lead to chronic pain and device rejection and failure.

Capsular contracture

is a response of the immune system to foreign materials in the human body. Medically, it occurs mostly in context of the complications from breast implants.

The occurrence of capsular contraction follows the formation of capsules of tightly-woven collagen fibers, created by the immune response to the presence of foreign objects surgically installed to the human body, e.g. breast implants, biological protection by isolation and toleration. Capsular contracture occurs when the collagen-fiber capsule tightens and squeezes the breast implant; as such, it is a medical complication that can be very painful and discomforting, and might distort the aesthetics of the breast implant and the breast. Although the cause of capsular contracture is unknown, factors common to its incidence include bacterial contamination, rupture of the breast-implant shell, leakage of the silicone-gel filling, and haematoma.

Moreover, because capsular contracture is a consequence of the immune system defending the patient's bodily integrity and health, it might reoccur, even after the requisite corrective surgery for the initial incidence.

Removal of the capsule

The correction of capsular contracture might require the surgical removal (release) of the capsule, or the removal. Closed capsulotomy (disrupting the capsule via external manipulation), a once-common maneuver for treating hard capsules, was discontinued because it might rupture the breast implant.

Ask the plastic surgeon to remove the capsules.

Plastic surgeons sometimes say it isn't necessary, thinking the body will clean up.

This is not always the case.

If they are left in the body you're having a chance to get sick(er) from them

Breast capsule persistence after breast implant removal. 1998 >>

The degree of an incidence of capsular contracture

is graded using the four-grade Baker scale:

Grade I — the breast is normally soft and appears natural in size and shape

Grade II — the breast is a little firm, but appears normal

Grade III — the breast is firm and appears abnormal

Grade IV — the breast is hard, painful to the touch, and appears abnormal

Mammography capsular contracture

Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studies >>

Pictures capsular contracture >>

Scientific research encapsulation / capsular contracture >>