Sir, Is the use of the breast implant capsule for reconstructION safe? In plastic and hand surgery, the sequelae that arthritis produces in the joints in their anatomy and functionality are of great personal, economic, and social impact and are worth treating. We will discuss in which patients, interpositional arthroplasty can be performed in the proximal interphalangeal joints with a breast capsule as an innovative technique, as well as the potential risk of this procedure. Among different kinds of arthritis, osteoarthritis (OA), rheumatoid arthritis (RA), and gouty arthritis (GA) are the 3 most prevalent diseases. OA is a noninflammatory degenerative joint disease that is caused by overuse of joints or aging, causing pain and disability to numerous people worldwide. RA is an autoimmune chronic inflammatory arthritis associated with the attack of autoantibody on the synovium and soft tissue, causing severe joint deformation and dysfunction. GA is a disease associated with uric acid crystal deposition, which causes severe pain during acute attacks and severe inflammation of joints.1–3 According to these findings, OA is the main cause of arthritis in the world and the one that most generates deformities. Our work focused on this group of patients. Compared to other diseases that destroy joints, inflammation is not as severe and its evolution and pathophysiology is different; information that is important to keep in mind for the reconstruction of the joints. In the prevalence of OA, it is estimated that up to 70%–90% of those over 75 years old have some radiological sign of OA in the hands,4 and it may produce symptoms in only 10% of these patients and is more disabling in women than in men.5–8 The prevalence of hand OA is more common in workers who perform long and repetitive manual labor compared to other types of workers.9 Currently, there are data to think that a genetic factor is present in up to 50% of cases in most forms of OA.10,11 After evaluating the deformity in the hands, we asked ourselves which reconstruction technique is the best to use; joint replacements are a good alternative with all the problems that these carry, such as synovitis, fractures of the implants or bone resorption, infections or other conditions, and poor functional results in the medium and long term; therefore, we considered that autografts were the best option for reconstruction in this patient. Reports in the literature have not shown any tissue that is suitable due to its physical characteristics in arthroplasties, and it was for this reason that we considered using the medium-thickness mammary capsule which could be found in mild or moderate capsular contracture, without any related breast pathology. We evaluated the studies by Kuriyama et al12 regarding the breast capsule and found that the scores demonstrated that the structure of the collagen fibers in the textured group were similar to normal collagen fibers. Many elastic fibers were observed in the capsular tissue. There was a significant increase in myofibroblasts in the capsule around.13 Properly discussing the breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) T-cell, it is a late disease (8–10 years) and appears with periprosthetic fluid or seroma, the most common presentation (90% of the cases), also pain and swelling in the breast and sometimes as a mass lesion.13 A combination of textured breast implant, bacterial contamination, and genetic predisposition seems to be necessary for BIA-ALCL to occur. There are 35 million patients with implants in the world, and at the present moment, 573 cases of BIA-ALCL have been reported.14–17 Systematic review of the literature via PubMed covering cases series, modes of presentation, cytological, histological and immunohistochemical features, and disease outcome, since 1997, shows that 518 cases throughout 25 countries have been registered on the American Society of Plastic Surgeons PROFILE registry, with an estimated risk for women with an implant of 1–3 per million per year. The neoplastic cells are highly atypical, consistently strongly positive for CD30, with 43%–90% also positive for EMA, and all are ALK-negative. Behavior is best predicted using a staging system for solid tumors.13 We consider that the comment of Dr. Marcus Vinicius Jardini Barbosa regarding the risk of acquiring anaplastic large cell lymphoma with the reconstruction technique is relevant; it is worth studying to be able to conclude if it is a safe technique. To conclude with these previous data, we consider that using the slightest contracture capsule that provides tissue in good macroscopic conditions in an asymptomatic patient in relation to the previous symptoms, the risk of suffering this disease in this surgery is really infrequent.