Post-Implant Morphological Changes of Mammary Tissue: Polyvinyl Sponge (Ivalon) vs. Silicone Breast Prosthesis

Research Article

Austin J Forensic Sci Criminol. 2015;2(1): 1011.

Post-Implant Morphological Changes of Mammary Tissue: Polyvinyl Sponge (Ivalon) vs. Silicone Breast Prosthesis

Audrey Ekhaguere, Mohammed Al-Tikriti*,Gerald Bertetta, Elizabeth Rega

Department of Medical Anatomical Sciences, Western University of Health Sciences, USA

*Corresponding author: Mohammed Al-Tikriti, Department of Anatomy, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 E 2nd St, Pomona, CA 91766, USA

Received: November 03, 2014; Accepted: January 12, 2015; Published: January 14, 2015


We report histomorphological changes of the capsules associated with Polyvinyl (Ivalon) sponge and silicone breast prosthesis implants, were removed from two Caucasian female cadavers between the ages of 50 and 80, and histologically analyze the reactions of the surrounding breast tissue to each type of breast implant.

Measurements and the volumes of the implants were taken and recorded. 1 cm x 1 cm tissue samples were cut and prepared through the tissue preparation for light microscopy method. The polyethylene bag did not completely prevent infiltration of living cells into the sponge. Many factors may have played a part in the extent of calcium deposition seen in the capsule and subcutaneous mammary tissue of the Ivalon breast as compared to the subcutaneous mammary tissue silicone breast implants.

Histological stains revealed living cell infiltration into the polyvinyl sponge, calcification of the Ivalon capsule, and calcium deposition in the subcutaneous mammary tissues of both the Ivalon and silicone breast implants.

Keywords: Cadaver; Breast implant; PVA; Ivalon; Silicone


Breast implants have been used for nearly half a century for both cosmetic and reconstructive purposes. Many commercially available synthetic polymers, such as polyvinyl alcohol (PVA), show physicochemical and mechanical properties comparable to those biological tissues to be substituted [1,2]. One of the earliest types of breast prosthesis was the Ivalon sponge. It is composed of polyvinyl alcohol, where formaldehyde, in the presence of sulfuric acid, reacts with 80% of its hydroxyl groups [3,4]. It showed no evidence of local systemic toxicity associated with PVA. In 1949, Grindlay and Clagett [5] established use of the polyvinyl alcohol sponge as a prosthetic implant. The polyvinyl sponge’s porous composition allowed for penetration by blood and other connective tissue of the body, in turn deeming it a living mass [6]. The polyvinyl sponge (commercially known as Ivalon) breast implants, composed of an oval piece of polyvinyl alcohol sponge enclosed in a polyethylene bag, were first used during the 1950s [4]. Organic fibrous tissue formation surrounding polyethylene implants had previously been documented, although there was a lack of long-term follow-ups beyond three years [7].

It was later evident that complications, including increased weight and hardening (possibly calcification), were associated with the implants [4]. In the early 1960s, breast implant prosthesis was revolutionized by the establishment of silicone gel breast implants. Due to rupture and many reported claims of connective tissue disease related to them, the FDA placed a ban on silicone gel breast implants for use in cosmetic purposes. The purpose of this report was to look at the histomorphological changes induced by these breast implants and hopefully draw a conclusion as to which type has the least reaction to the surrounding connective tissue of the breast.

Materials and Methods

A pair of polyvinyl sponge breast implants was found in a 78 year old Caucasian female cadaver. The implants with the capsules were removed and weighed. Another pair of silicone breast implant that was found in Caucasian female cadaver between the ages of 50 and 65, was also removed, and their volumes was calculated by using the displacement method: a beaker was filled to the 675 ml line with tap water. The length and volume of the implants were measured and recorded (Table 1). Pictures of the Ivalon sponge implant at each of the aforementioned distances were all taken. 1 cm x 1 cm samples were cut from the polyvinyl sponge, its hardened capsule, the subcutaneous tissue directly underlying the capsule, the tissue directly surrounding the silicone breast implant (considered the capsule), and the subcutaneous tissue underlying the silicone capsule. As the tissue samples have already been formalin preserved, the samples were then dehydrated, cleared, molded into a paraffin block, sectioned at five μm (micrometers), and placed on a slide, as per standard histological procedures. The slides were then stained with hematoxylin and eosin (H&E), Alizarin Red, and Masson’s Trichrome. The slides were mounted and analyzed.