Management of asymptomatic silicone-injected breast with reduction mammoplasty

Abstract

Even though Silicone injection for breast augmentation has been related to disastrous long-term effects and complications, some patients do not develop significant symptoms at all (asymptomatic). Unfortunately, the management of asymptomatic Silicone-injected breast is still unclear and has never been reported exclusively. We present two cases of asymptomatic patients with a history of liquid Silicone injections who refused to have a mastectomy. They were concerned with the breast ptosis and chose to undergo reduction mammoplasty to improve the appearance of the breasts. Magnetic resonance imaging may be useful as an additional screening tool to confirm the diagnosis and exclude the presence of malignancy in breasts with injected Silicone. We believe that breast reduction may be the alternative option for women with a history of liquid Silicone injection who have no symptoms but desire to preserve their breasts and improve their aesthetics.

Treatment of giant siliconomas of the breasts after injection of silicone

“…Implant based reconstruction after mastectomy has been reported in several case series with various complication rates and most authors advocating for immediate reconstruction [ 15 , 16 ]. Some authors have reported reconstruction after non total removal of breast tissue, either with implant insertion and mammaplasty after partial excisions of granulomas [ 17 ] or with reduction mammaplasty reported in two asymptomatic patients [ 18 ]. Bilateral breast siliconoma which was treated by total mastectomy with two stage tissue expander-prosthesis reconstruction has also been reported in one case [ 19 ].…”

Complications of Use of Injected Liquid Silicone in Breast: A Case Report

“…Complications serious and also development of ASIA syndrome. Several complications were mentioned by silicone injection in the breasts, legs, buttocks determining serious ulcers [9][10][11].…”

“…The impossibility of removing all the injected material, as well as the necrotic, fibrotic and cicatricle tissues present makes difficult the treatment [1][2][3]. Late complications are associated with typical reactions to the foreign body, being encapsulated and, in the long term, wrapped in calcified fibrosis that acquires stone consistency and the fibrosis determined by the tissue reaction makes it difficult to visualize malignant lesions, delaying the diagnosis [1][2][3][4].…”

Breast augmentation in the transgender patient: narrative review of current techniques and complications

“…Unfortunately, some transfeminine patients seek "street" hormones and illicit silicone injections as an alternative to physician-prescribed gender affirming medications and procedures. These substances have been issued warnings by the U.S. Food and Drug Administration, but the lowcost and the ability to obtain these substances outside of the medical setting make them unfortunately attractive options for patients who distrust or cannot access the medical community (17,18). If a history of self-obtained substances is disclosed, providers should take this into account when formulating a surgical plan (19).…”