[doi: 10.5505/2017ichc.PP-04]
The Effect of Hyaluronic Acid Application on the Perisilicon Capsule Structure
Sedat Tatar1, Ainura Sarybaeva2, Kemal Fındıkçıoğlu2, Cemile Merve Seymen3, Çiğdem Elmas3, Osman Latifoğlu22Department of Plastic and Reconstructive Surgery, Medical School, Gazi University, Ankara, Turkey
3Department of Histology and Embryology, Medical School, Gazi University, Ankara, Turkey
Introduction and AIM: The purpose of this study, to investigate the effect of hyaluronic acid which is well known agent that effect wound healing and fibrosis in many different ways on perisilicone capsular formation that is a foreign body reaction that occurs in patients who receive silicone implants.
METHODS: 20 Wistar Albino rats were divided into 4 equal groups. Equal sized silicon blocks inserted the subcutaneus area of rat dorsum. Group 1A and 2A had only silicone block, group 1B and Group 2B was injected by 0,2 cc hyaluronic acid around silicone blocks. Group 1A and 1B were sacrified at fourth week, group 2A and 2B were sacrified at eighth week. The capsule thickness, collagen pattern, inflamatuar cells and fibrosis were determinated by Masson’s Trichrome, HSP-47 and TGF-β1 stainings.
RESULTS: The capsule was composed of distinct layers, was similar in consistency in both groups, but of variable thickness, which differed significantly between each groups (p<0.05). Capsular thickness of Group 1B, which had hyaluronic acid was significantly had a thicker capsule. Group 2B had the thickest capsule and had the highest level of TGF-β1 which is a sign of fibrosis. HSP 47 levels were increased depending on amount of collagen towards Group 2B, but density of HSP 47 decreased towards Group 2B because of increased capsular thickness.
CONCLUSION: It was concluded that; the heat shock protein HSP-47 was found dense especially during the initial preiod of stress (1 month application groups), local hyaluronic acid administration was not prevent capsular contracture development but caused an increase of the thickness in the capsule. These data was also supported by TGF-β1 stainings. Crosslinked hyaluronic acid based fillers are useful material for soft tissue augmentation and correct wrinkles for aesthetical practice, but we have to be careful about these fillers if we want to use for decrease fibrosis and capsular thickness around silicone implants because of we saw negative effect on fibrosis and capsular formation.
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