Siliconomas: Therapeutic considerations. Algorithm

Abstract

The injection of silicone oils has been used to modify body contours around the world and especially in Japan, since 1940, most commonly to increase breast size.As surgeons, we find ourselves increasingly being called to deal with problems generated by this illegal form of breast augmentation-bilateral breast tumors, some painful, some not; hard masses that are often confused with advanced breast cancer; and axillary tumors-all caused by silicones. To this is added the extreme difficulty ruling out breast cancer through physical examinations, mammography, ultrasound, and even magnetic resonance imaging (MRI) with gadolinium. Our experience, over 20 years treating and investigating this pathology, has clearly shown us that, to treat these patients with such complex disease, a multidisciplinary therapeutic team is required. Moreover, that team must have a comprehensive vision and be committed to tailoring treatment to each patient individually. The team also must act in a coordinated manner, addressing all the different implications of disease, whether local or systemic, physical or psychological. The injection of silicones and other oils has had an unfavorable social impact, because it incapacitates a large number of people during the most productive years of their life. We will now present the appropriate therapeutic approaches for each form of mammary siliconoma presentation.