Iatrogenic intrathoracic encapsulated siliconoma from a ruptured breast implant

Abstract

Our patient was a 57-year-old woman with a history of bilateral retropectoral silicone breast augmentation and axillary hyperhidrosis who underwent a bilateral thoracic sympathectomy via video-assisted thoracoscopic surgery by a surgeon at an outside hospital approximately 20 years ago. The left side required an open thoracotomy. Shortly after the surgery, she developed a left-sided Baker 4 capsular contracture and the left implant was noted to be ruptured. Both implants were exchanged. Several years later the patient began to experience progressive fatigue. Work-up revealed a left lung nodule and she underwent a biopsy that confirmed silicone granulomas. It was hypothesised that at the time of her initial thoracotomy the implant was violated resulting in silicone spillage into the thoracic cavity. The patient was referred to our institution for advanced management of her intrathoracic silicosis. The patient underwent bilateral removal of her silicone implants, total capsulectomy and needle-localised removal of her left thoracic silicone masses. She had an uneventful postoperative course with resolution of her fatigue.

Iatrogenic Rupture of Saline Breast Implant Following Robotic-Assisted Lung Surgery

“…For thoracic surgery, however, no study has been available to help estimate the incidence of iatrogenic breast implant rupture. To date, only a small number of case reports have been published to describe this possible complication after video-assisted thoracoscopic surgery (VATS) [5,6] or after chest tube insertion [7]. To our knowledge, there has been no report of breast implant rupture following a robotic-assisted thoracic surgery (RATS), an increasingly adopted, minimally invasive surgical approach.…”