Fig. 5

The development of a capsule over time after breast implant insertion. Days after insertion of the implant, cells such as granulocytes, lymphocytes, and fibroblasts surround the implant and contribute towards the formation of a normal and thin capsule. Over time, more fibroblasts and dendritic cells can be recruited to the implant site, leading to synthesis of more ECM proteins. Type III collagen in the initial provisional matrix is replaced with type I collagen as more fibrous ECM is formed around the implant. Encapsulation is part of the normal physiologic FBR, however, excessive deposition of fibrous ECM around the implants contracts the implant and cause capsular contracture