Invited Response on: Perceptions of Silicone Structure and Function
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EDITOR’S INVITED COMMENTARY
Invited Response on: Perceptions of Silicone Structure and Function Maria-Isabel Caravantes-Cortes1 • Ernesto Roldan-Valadez2,3 Shirley-Yoselin Salazar-Ruiz4
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Received: 7 April 2020 / Accepted: 8 April 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Level of Evidence V This journal requires that authors assign a level of evidence to each article. 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. Dear Editor, On behalf of my coauthors, I thank the authors of the letter for their interest in our publication [1] and detailed workup of its content. We want to address briefly the main comments raised. We want to emphasize as a starting point, the importance of what the term silicone means. However, in medical literature, the use of this term is understandable and uniform, because in the search engines PubMed, Cochrane, etc., prostheses manufactured with polydimethylsiloxane (PDMS) have been referred to as silicone implants for several decades. More than 11,000 publications with these words appear in search engines, reflecting that for the medical community, PDMS manufactured products are referred to as silicone products.
& Maria-Isabel Caravantes-Cortes [email protected] 1
Plastic Surgery Unit, Corporacio´n Medicopla´stica, Hospital Espan˜ol de Me´xico, Av. Ejercito Nacional 613, Piso 7, consultorio 703, Col. Granada, Alcaldı´a Miguel Hidalgo, 11520 Mexico City, Mexico
2
Directorate of Research, Hospital General de Me´xico ‘‘Dr. Eduardo Liceaga’’, Mexico City, Mexico
3
Department of Radiology, I.M. Sechenov First Moscow State Medical University, (Sechenov University), Moscow, Russia
4
Department of Surgery, Hospital General de Zona 71 Instituto Mexicano del Seguro Social ‘‘IMSS’’, Veracruz, Mexico
The basic structure of the current silicone breast implants is, in general terms, a silicone elastomer device, and its content is a mixture of high and low molecular weight polydimethylsiloxane (PDMS) monomers, which give specific characteristics to the implant, depending on the relationship between them [2]. The biocompatibility of breast prostheses is determined, among other factors, by the textured characteristics of the implants. In vitro study of the reaction of macrophages to the different textures demonstrated that the inflammatory response mediated by these cells varied between the different types of implants and also between smooth and textured models and their different roughness measurements. [3, 4]. The kind of texture of the implant cover is a variable in some brands where a higher incidence of alterations such as capsular contracture and pathologies such as BIA-ALCL has been reported [3]. It has been reported that the texture of the surface of the implants and the roughness of the implants play an essential factor in the stimulation of macrophages, as mentioned pr
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