Uncommon complications of breast prostheses

Rubio, Nancy Sanchez; Menéndez, Beatriz; Muñoz, M. Duque; Fernández, M. Montes; Fernández, María José Ciudad

doi:10.1016/j.rxeng.2020.01.010

Cited by 4 publications

(4 citation statements)

References 49 publications

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“…The increasing number of patients with breast implants has in turn increased the likelihood of less common complications, which include seromas or late infection, breast lymphadenopathy, granulomas in the implant capsule, which in some cases can extend beyond the fibrous capsule, desmoid tumors and large cell anaplastic lymphoma [13,39].…”

Section: Discussionmentioning

confidence: 99%

Stromal-cellular remodeling of breast tissue after silicone implant damage

Dadayan,

Adamovych,

Simonov

et al. 2024

Rep. of Morph.

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One of the current vectors of modern reconstructive and cosmetic surgery is augmentation mammoplasty - an operation to enlarge the mammary glands. The breast implant is well tolerated by the body, as the immunogenicity of its material is extremely low. At the same time, the silicone gel of the implant is a foreign object and the surrounding breast tissues give a stereotypical response in the form of growth of the connective tissue stroma with the formation of a capsule around the implant and the appearance of focal cellular infiltrates. Modern breast implants, unlike implants of previous decades, are more sophisticated in their structure, and the level of protection against damage is much higher. A complication associated with the long-term use (up to 20 years) of implants, where low-quality silicone or industrial silicone was used as a filler, is the penetration of low-molecular-weight particles of the implant through its shell to the surrounding tissues with the subsequent formation of silicone granules. In the vast majority, such changes develop after mechanical traumatization of the implant. The purpose of the study is to establish the morphological criteria of the reaction of breast tissue after silicone implant damage. The material for research was histological micropreparations of breast tissue from the archive of the "Grace Clinic" (Kyiv), with the mutual consent of patients who applied for repeated mammoplasty. The duration of the implants in the breast gland was from 6 to 20 years. The age range of the women was from 36 to 53 years. On preparations stained with hematoxylin and eosin, tissue biopsies of the glands of 9 patients with a diagnosis of deformation of silicone implants and violation of the integrity of their wall were presented. The micropreparations were visualized using a UlabXSP-137TLED light microscope at various magnifications and photographed with an XCAM 1080P camera. The study of histological preparations of soft tissues of the breast glands, from which silicone implants were removed, established changes in stromal-cellular elements, namely: decorated fibrous structures accumulated in the form of dense capsules with elements of local contractures; from the side of cellular elements, the most demonstrative were cellular infiltrates, which included macrophages, lymphocytes, and plasma cells, which indicated a high probability of a chronic inflammatory process. A large number of giant multinucleated cells of foreign bodies were present in practically all examined sections, which indicated the impossibility of macrophages to complete phagocytosis with lysis of the phagocytosed material, which by its chemical composition is the silicone of the implant. All the described phenomena can be interpreted as a natural reaction of the tissues to the implant, the contents of which got into the soft tissues of the breast. Thus, the presence of numerous giant multinucleated cells of foreign bodies, dense capsules with elements of local contractures, and a significant predominance of macrophages, lymphocytes, and plasma cells in cellular infiltrates over other cellular elements can be considered a morphological criterion for the reaction of breast tissue to silicone implant damage.

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Section: Discussionmentioning

confidence: 99%

Stromal-cellular remodeling of breast tissue after silicone implant damage

Dadayan,

Adamovych,

Simonov

et al. 2024

Rep. of Morph.

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“…Adjuvant chemotherapy, based on anthracycline with brentuximab vedotin following the ECHELON II trial results, is dedicated to patients with advanced disease [60,61]. As indicated by Rubio et al if the implat removal was performed with no residual disease, the further follow-up requires a CT or a PET/CT scan assessment every six months for two years depending e patient's clinical picture [62].…”

Section: Breast Implant-associated Anaplastic Large Cell Lymphomamentioning

confidence: 99%

Current Challenges in Breast Implantation

et al. 2021

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Breast implantation (BI) is the most common plastic surgery worldwide performed among women. Generally, BI is performed both in aesthetic and oncoplastic procedures. Recently, the prevalence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) or breast implant illness (BII) has aroused concerns. As a result, several countries, like Australia, Korea or the United Kingdom, introduced national registries dedicated to the safety and quality of BI surgeries. This narrative review aimed to focus on the clinical challenges, management and the current state of knowledge of BI. Both short and long-term outcomes of BI are determined by various alternatives and differences, which surgeons must consider during the planning and performing breast augmentation along with further complications or risk of reoperation. Proper preoperative decisions and aspects of surgical technique emerged to be equally important. The number of performed breast reconstructions is increasing, providing the finest aesthetic results and improving patient’s quality of life. Choice of prosthesis varies according to individual preferences and anatomical variables. A newly diagnosed cases of BIA-ALCL with lacking data on prevention, diagnosis, and treatment are placing it as a compelling medical challenge. Similarly, BII remains one of the most controversial subjects in reconstructive breast surgery due to unspecified diagnostic procedures, and recommendations.

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“…Breast augmentation surgery, like any invasive procedure, is associated with complications, the most common of which include bleeding such as the development of hematomas, infection, development of seroma, sensory alterations in the nipple or breast, implant rupture/rotation, capsular contracture, and galactorrhea [ 3 ]. Less common events include silicone-induced granulomas, mammary fibromatosis, or the development of tumors such as desmoid tumors or breast implant-associated anaplastic lymphoma [ 4 ]. Rare cases of benign pleural effusion have been reported following breast augmentation surgery with silicone breast implants.…”

Section: Introductionmentioning

confidence: 99%

Pleural Effusion as a Potential Complication of Foreign Body Reaction to Silicone Breast Implants: A Case Study

Abdeen¹,

Ortiz²,

Cala-Garcia³

et al. 2023

Cureus

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Breast augmentation surgery, like any other surgery, has potential complications, including the less common complication of pleural effusion. We present a unique case of a 44-year-old female who developed pleuritic chest pain and shortness of breath 10 days after her breast augmentation surgery, with no prior history of cardiac or autoimmune conditions. The temporal relationship between the surgery and the onset of symptoms suggested a possible direct link to the implants. Imaging showed a small- to moderate-sized left pleural effusion, and pleural fluid analysis revealed findings suggestive of a foreign body reaction (FBR), including evidence of mesothelial and inflammatory cells with a lymphocyte percentage of 44% and monocytes of 30%. The patient received intravenous steroids at a dose of 40 mg every eight hours for three days while hospitalized, followed by a tapered oral dose of steroids upon discharge, for over three weeks. Follow-up imaging studies showed complete resolution of the pleural effusion. The diagnosis of pleural effusion resulting from FBR to silicone gel-filled breast implants involves a clinical history, cytopathological examination, and the exclusion of other potential causes. This case highlights the importance of considering FBR as a potential cause of pleural effusion post-breast augmentation surgery.

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Uncommon complications of breast prostheses

Cited by 4 publications

References 49 publications

Stromal-cellular remodeling of breast tissue after silicone implant damage

Stromal-cellular remodeling of breast tissue after silicone implant damage

Current Challenges in Breast Implantation

Pleural Effusion as a Potential Complication of Foreign Body Reaction to Silicone Breast Implants: A Case Study

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