Silicone Migration and Late Hematoma following Silicone Implant Rupture: Case Report and Literature Review

Dean, Riley A.; Glener, Adam D.; Thomas, Analise B.; Glener, Steven R.; Kurtovic, Silvia; Erdmann, Detlev

doi:10.1097/gox.0000000000001849

Cited by 8 publications

(5 citation statements)

References 26 publications

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“…The second most common place for free silicone migration is regional lymph nodes (axillary lymph nodes), and silicone aggregates in lymph nodes can also mimic malignant processes [ 7 , 8 ]. Occasionally, free silicone travels to distant regions (arm/forearm, thoracic cavity, abdominal wall, legs, back) [ 9 , 10 ]. In order to avoid these complications, it is of crucial importance to detect implant rupture as soon as possible and to remove or replace a ruptured implant [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

The Value of Ultrasound in the Evaluation of the Integrity of Silicone Breast Implants

et al. 2021

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Background and Objective: Breast implant surgery for cosmetic purposes is the most popular plastic surgery and it has been performed for over 100 years. Rupture of silicone gel-filled breast implants usually is asymptomatic and is one of the more dangerous complications due to free silicone migration. The aim of our study was to evaluate the diagnostic value of ultrasound (US) in the evaluation of the integrity of silicone breast implants and identify the main sign of intact and ruptured breast implants. Patients and Methods: In this retrospective study, the medical documentation of women who underwent breast implant surgery and US checkups at Tautrimas Aštrauskas Clinic in Kaunas, Lithuania, during 2015–2020 was analyzed. The patients were divided into two groups: patients with intact and ruptured breast implants. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) as well as the signs of implant integrity of US examination were evaluated. Results: In this study, 76 women with bilateral breast implants (n = 152) were reviewed. On a US examination, ruptured implants were found in 41.1% (n = 61) of the cases; of them, 78.7% (n = 48) of the cases had ≥2 US signs of a ruptured implant, and in all these cases, implant rupture was confirmed at surgery. Overall, one US sign of a ruptured implant was found in 21.3% (n = 13) of the cases. Of them, inhomogeneous content in all cases (n = 3) was found in the intact implant group, and an abnormal implant shell was documented more often in the ruptured implant group, not intact one (n = 9, 90% vs. n = 1, 10%). US had a diagnostic accuracy of 94.7%, sensitivity of 98.3%, specificity of 89.2%, PPV of 93.4%, and NPV of 97.1% in the evaluation of implant integrity. Conclusions: Our results show that US is a very reliable alternative in evaluating breast implant integrity and could be the investigation of choice for implant rupture, while MRI could be advocated only in inconclusive cases. Uneven implant shell was found to be the most important US sign of breast implant rupture. Based on the findings, we recommend performing US examination after breast augmentation surgery with silicone gel-filled implants annually.

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Section: Introductionmentioning

confidence: 99%

The Value of Ultrasound in the Evaluation of the Integrity of Silicone Breast Implants

et al. 2021

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“…it is thought that silicone can migrate through hematogenous or lymphatic routes [ 31 ]. Various distant migration sites of silicone from breast are reported, including the upper extremity, groin and thoracic cavity [ 32 , 33 ]. Lymphatic migration of silicone in the groin lymph node is considered as a potential route for dissemination.…”

Section: Discussionmentioning

confidence: 99%

Vulvar migration of injected polyacrylamide hydrogel following breast augmentation: a case report and literature review

Wen,

Li,

Chi

et al. 2024

BMC Women's Health

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Background Vulvar migration is a rare complication of filler injection for breast augmentation, generally presenting as repeated pain and fever. We will report a case of woman with polyacrylamide hydrogel breast injection develops vulvar abscess. Case presentation A woman with a history of polyacrylamide hydrogel breast injection was noted to have vulvar abscess due to migration of filler materials. Filler removal surgery and vacuum sealing drainage was performed for this patient. The patient was discharged from the hospital with no further complications. After a review of pertinent literature, only four previous case reports are found. Local inflammatory response, infection, large volume injections, inframammary fold destruction, hematogenous or lymphatic migrate, trauma, gravity and external pressure could play essential parts in the migration of injected filler. Conclusion Polyacrylamide hydrogel migration poses a worldwide challenge, necessitating personalized solutions. Our case study underscores the importance of comprehensive examinations for individuals with a history of filler breast injection when suspecting vulvar filler migration.

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“…This comparison of late breast hematomas with chronic subdural hematomas was described by Roman [23] in 2005 even. In the past year, 2018, two cases of late hematoma were reported: Kim et al [31] explained its development as a consequence of severe capsular contracture, while Dean et al [32] described a case of silicone extravasation that may have led to chronic lymphocytic granulomatous reaction and a consequent recurrent acute-on-chronic hematoma. Grippaudo et al [3] in 2013 reported a singular case of late hematoma developed 2 years after breast surgery, due to mechanical friction in the space between the two layers of a double capsule.…”

Section: Discussionmentioning

confidence: 99%

An unusual case of late hematoma after implant-based breast reconstruction mimicking an anaplastic large cell lymphoma: a case report and literature review

et al. 2021

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Late hematoma associated with breast implants used in esthetic and reconstructive breast surgery represents a rare entity. These hematomas do not have a clear etiology, but triggering events like trauma, anticoagulant use, capsule contracture, or chronic inflammation are reported in literature. We describe an 82-year-old patient who developed a unilateral intra-capsular hematoma 19 years after mastectomy and breast reconstruction with McGhan 445 g implant. Differential diagnosis with anaplastic large cell lymphoma (ALCL) was considered and potential causes of hematoma were evaluated. Constant pressure forces on chest wall were defined as pathophysiological cause. A systematic literature review concerning late hematoma cases was carried out, focusing on late hematoma etiology and various surgical treatments.Level of evidence: Level V, diagnostic study.

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Silicone Migration and Late Hematoma following Silicone Implant Rupture: Case Report and Literature Review

Abstract: Supplemental Digital Content is available in the text.

Cited by 8 publications

References 26 publications

The Value of Ultrasound in the Evaluation of the Integrity of Silicone Breast Implants

The Value of Ultrasound in the Evaluation of the Integrity of Silicone Breast Implants

Vulvar migration of injected polyacrylamide hydrogel following breast augmentation: a case report and literature review

An unusual case of late hematoma after implant-based breast reconstruction mimicking an anaplastic large cell lymphoma: a case report and literature review

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