Surgical management of silicone mastitis: Case series and review of the literature

Anthony Echo, Leo R. Otake, Babak J. Mehrara, Ursula M. Kraneburg, Nikhil Agrawal, Andrew L. Da Lio, William W. Shaw, Gordon K. Lee

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Free silicone injection for breast augmentation, which became widespread in the 1960s and continues illicitly to this day, has well-known adverse effects. In this retrospective chart review of 14 patients treated for silicone mastitis from 1990 to 2002, we present our experience with the surgical management of patients with silicone mastitis. Methods: All the patients were women, ranging in age from 49 to 76 years old (mean age = 58.8). Patients presented to us a mean of 29.9 years after their free silicone breast injection. Treatment modalities were analyzed, and, specifically, methods of breast reconstruction involving autologous tissue transfers, implants, or a combination were evaluated. Results: The majority of patients (12 of 14) required mastectomies for extensive silicone-infiltrated tissues. The remaining two patients had focal areas of disease and were successfully treated with excision and local breast parenchyma flaps. Autologous reconstruction was performed with a total of 20 flaps, including 12 free transverse rectus abdominis myocutaneous flaps, 4 free superior gluteal artery perforator (SGAP) flaps, and 4 pedicled latissimus dorsi (LD) flaps. Two patients had bilateral implant-based breast reconstruction. Conclusion: A variety of reconstructive options are available for patients presenting with silicone mastitis. Once an appropriate breast cancer workup has been performed, the surgical goal is to excise as much of the silicone-infiltrated tissues as possible before reconstruction. To our knowledge, this is the first reported series that incorporates the use of SGAP and LD flaps as a means of autologous tissue reconstruction for silicone-infiltrated breasts. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Original languageEnglish (US)
Pages (from-to)738-745
Number of pages8
JournalAesthetic Plastic Surgery
Volume37
Issue number4
DOIs
StatePublished - Aug 2013

Keywords

  • Breast reconstruction
  • Liquid silicone injections
  • SGAP flap
  • Silicone mastitis
  • Superior gluteal artery perforator flap
  • TRAM flap
  • Transverse rectus abdominis myocutaneous flap

ASJC Scopus subject areas

  • Surgery

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