scholarly journals Life-Saving Silicone Breast Implant After Firearm Injury: Case Report and Treatment Recommendations

2020 ◽  
Vol 6 ◽  
pp. 2513826X1989882
Author(s):  
Giancarlo McEvenue ◽  
Anastasia Oikonomou ◽  
Noah Ditkofsky ◽  
Joan Lipa
Keyword(s):  
Breast Implant ◽  
Breast Implants ◽  
Operative Management ◽  
Implant Removal ◽  
Silicone Implants ◽  
High Resolution Computed Tomography ◽  
Firearm Injury ◽  
Firearm Injuries ◽  
Life Saving ◽  
Ballistic Injury

Breast augmentation with silicone implants is one of the most commonly performed operations by plastic surgeons. Here, we report a case of a 30-year-old female patient with a ballistic injury to bilateral breast implants, where the silicone implant was likely responsible for deflecting the bullets trajectory and saving the women’s life. Ballistics analysis of bullet trajectory was performed with high-resolution computed tomography scan analysis. Operative management was implant removal, pocket irrigation, and a short course of antibiotics. A literature review was performed on all previously published breast implant–related firearm injuries. The authors advise operative management with implant removal and delay of replantation for minimum 6 months’ time.

scholarly journals A population-based study of breast implant illness

2021 ◽  
Vol 48 (4) ◽  
pp. 353-360
Author(s):  
David A. Magno-Padron ◽  
Jessica Luo ◽  
Terry C. Jessop ◽  
Jared W. Garlick ◽  
Joanna S. Manum ◽  
...  
Keyword(s):  
Hair Loss ◽  
Joint Pain ◽  
Breast Implant ◽  
Breast Implants ◽  
Population Based ◽  
Implant Removal ◽  
Silicone Implants ◽  
Population Based Study ◽  
Adverse Health Effects ◽  
Social Media Platforms

Background Despite evidence supporting the safety of breast implants, some women associate their implants with adverse health effects and have called this syndrome “breast implant illness.” We sought to characterize breast implant illness symptoms and to report how implant removal affects their symptoms.Methods An anonymous 20 question survey was administered to the Facebook group: “UTAH Breast Implant Illness” to characterize the symptoms these women attributed to their breast implants. Several questions allowed us to evaluate how implant removal affected women’s symptoms.Results Of the 182 respondents, 97% report that implants negatively affect their health and 95% identify these symptoms with breast implant illness. Ninety-six percent of respondents had implants placed for cosmetic reasons and 51% had silicone implants. The most common symptoms associated with breast implant illness are brain fog (95%), fatigue (92%), joint pain (80%), and hair loss (74%). Sixty percent of respondents learned about breast implant illness from family/friends and/or social media platforms (56%), 40% of respondents had their implants removed, and 97% report relief of their symptoms post-removal (23% complete, 74% partial). Following explantation, there was a significant improvement in all but one reported symptom. An association was found between the number of symptoms reported prior to explantation and the number of symptoms resolving following explantation.Conclusions Breast implant illness is a syndrome characterized by fatigue, decreased focus, hair loss, and joint pain after the placement of breast implants. Nearly all patients report improvement of symptoms after implant removal. Significant efforts should be made to better understand breast implant illness and its etiology.

scholarly journals Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Case Report

2021 ◽  
Vol 4 (1) ◽  
pp. 28-34
Author(s):  
Kumkum Vadehra ◽  
Jennifer Cai ◽  
Rashmi Rekha Bhuyan ◽  
Ping Ji ◽  
Rose Venegas ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Anaplastic Large Cell Lymphoma ◽  
Cell Lymphoma ◽  
Breast Implant ◽  
Fluid Collection ◽  
Breast Implants ◽  
Large Cell ◽  
Silicone Implants ◽  
Axillary Lymph ◽  
Large Cell Lymphoma

Breast implant-associated anaplastic large cell lymphoma (ALCL) is a recently recognized type of T-cell lymphoma that can develop following breast implants, with morphologic and immunophenotypic features indistinguishable from those of ALK-negative ALCL. Here we report a case of a 58-year-old woman with a history of subglandular silicone implants placed for bilateral breast augmentation 25 years ago, who presented with bilateral breast pain and was found to have bilateral Baker Grade III capsular contracture, and heterogenous fluid collection centered near the left third costochondral articulation, a suspicious left chest wall lesion, and left axillary lymphadenopathy on imaging. A left axillary lymph node core biopsy and an aspiration of the fluid were performed, and no malignant cells were identified. The patient underwent bilateral removal of breast implants and total capsulectomies. Microscopic examination of the capsule surrounding the left breast implant revealed large pleomorphic tumor cells in a fibrinous exudate. By immunohistochemistry, the tumor cells were found to be positive for CD3 (subset), CD4, CD7, CD30 (strong and uniform), and CD43, and negative for CD2, CD5, CD8, and ALK1, supporting the diagnosis of breast implant-associated ALCL. No lymphoma cells were identified in the right breast capsule, confirmed by CD30 stain. Breast implant-associated ALCL is a very rare disease that can develop many years after breast implant placement. Proper evaluation with breast imaging and pathologic workup is essential to confirm the diagnosis in suspected cases. Our case highlights that adequate sampling is important in the investigation of patients with suspected breast implant-associated ALCL.

scholarly journals Experimental model of capsular contracture in silicone implants

2003 ◽  
Vol 18 (spe) ◽  
pp. 22-28 ◽  
Author(s):  
Érika Malheiros Bastos ◽  
Miguel Sabino Neto ◽  
Lydia Masako Ferreira ◽  
Élvio Bueno Garcia ◽  
Richard Eloin Liebano ◽  
...  
Keyword(s):  
Plastic Surgery ◽  
Experimental Model ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Breast Implants ◽  
Silicone Implants ◽  
Frequent Complication

The breast implant procedure is one of the most performed into Plastic Surgery and the contracture that occurs the capsule formed around the breast implants one of most frequent complication. We describe here one experimental model of capsule contracture in rats.

Role of mammography to assess complications of silicone gel breast implants

1995 ◽  
Vol 3 (3) ◽  
pp. 1-9 ◽  
Author(s):  
Walter Peters ◽  
Dennis Smith ◽  
Harvey Grosman ◽  
Victor Fornasier
Keyword(s):  
Breast Imaging ◽  
Breast Implant ◽  
Breast Implants ◽  
Cystic Mass ◽  
Implant Removal ◽  
The Other ◽  
Serous Effusion ◽  
Implant Rupture ◽  
Sensitivity Rate

Mammography is not accurate to predict implant rupture in most patients. Its sensitivity rate is only 11 to 16%. However, two mammographic findings appear to suggest implant rupture: the appearance of large areas of implant herniation, and the appearance of silicone globules lying outside the margins of the implant. Mammography is also helpful to predict capsular calcification and to assess certain complications of retained breast implant capsules. Two patients presented with retained capsules which had not resolved, two and five years after implant removal. One patient developed a spiculated mass, suspicious for carcinoma, that proved to be a cystic mass resulting from persistent serous effusion. The other patient demonstrated a large densely calcified capsule which interfered with breast imaging.

scholarly journals Thoracic migration of silicone gel after breast implant rupture: a case report and literature review

2021 ◽  
Author(s):  
Benedetta Fanelli ◽  
Marco Marcasciano ◽  
Stefano Lovero ◽  
Luca Codolini ◽  
Donato Casella ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Biological Membrane ◽  
Breast Implant ◽  
Granulomatous Inflammation ◽  
Breast Implants ◽  
Silicone Implants ◽  
Axillary Lymph ◽  
Implant Rupture ◽  
Silicone Gel ◽  
Breast Implant Rupture

AbstractNowadays silicone is a widespread material for medical devices. In particular, it is commonly used for implants manufacturing, for that patients undergoing breast augmentation or breast reconstruction after mastectomy. However, the use of silicone implants is not free from risks. Ruptures of silicone breast implants are uncommon, in general post-traumatic or iatrogenic, and usually related to implant’s wall weakness of unknown origin but probably due to biochemical reactions that cause wall rupture. As a consequence of a rupture, silicone gel from damaged implants may have a continuity migration to the chest wall, axillae, and upper extremities, resulting in granulomatous inflammation or siliconoma, or a lymphatic migration to axillary lymph nodes. In this regard, silicone thoracic migration is extremely rare, and nowadays a leakage is unlikely to happen with more modern cohesive silicone gel implants. Nevertheless, procedures such as thoracic surgery and thoracotomies may be responsible for accidental breast implant rupture, capsular discontinuity, and eventually intrathoracic silicone migration, especially when dealing with older generations of breast implants. We report a rare case of a 75-year-old woman presenting with pleural silicone effusion, 18 years after a right breast reconstruction for breast cancer, followed by right upper lobe resection for a lung carcinoma. A combination of muscular flap and DTI pre-pectoral breast reconstruction with biological membrane (ADM) has been used for treatment. Literature was reviewed for cases of breast implants free silicone localization in the chest cavity, focusing on previous surgeries, anamnestic relevances, and surgical management.Level of Evidence: Level V, risk/prognostic study.

scholarly journals Diagnosis, investigation and management of breast implant illness

2021 ◽  
Vol 4 (1) ◽  
pp. 9-21
Author(s):  
Daniel WH Wong ◽  
Tai K Lam
Keyword(s):  
Case Reports ◽  
Breast Implant ◽  
Case Series ◽  
Breast Implants ◽  
Silicone Implants ◽  
Exact Nature ◽  
Cochrane Central Register ◽  
Case Control Studies ◽  
Silicone Breast Implants ◽  
Retrospective Cohort Studies

Introduction: An increasing pool of literature proposes a link between silicone implants and autoimmune-related symptoms known colloquially as breast implant illness (BII). We describe the history of BII, reported symptoms, risk factors and previously published diagnostic criteria to aid clinicians in the diagnosis, investigations and management of patients presenting with symptoms that they attribute to their silicone breast implants. Methods: A literature search was performed using MEDLINE®, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effect (DARE) and PubMed in September 2018. The search terms ‘autoimmune inflammatory syndrome induced by adjuvants’, ‘breast implants’ and ‘silicone’ were used alone and in combination. Results: Thirty-four studies were reviewed including three case reports, 12 case series, 14 retrospective cohort studies, four case control studies and one prospective cohort study. Within this cohort, 18 studies were found regarding the explantation of implants relating to BII. Conclusion: Studies have demonstrated no association between silicone breast implants and any known autoimmune diseases, but there exists a pool of literature suggestive of a relatively undefined condition colloquially known as BII. Serological testing and imaging play an important role in the assessment of patients to exclude other pathology, but these tests remain non-diagnostic for BII. Although medical treatment has shown promise, there is no established treatment for patients. The surgical explantation of implants appears to have positive outcomes for patients; however, the exact nature of the surgery required to achieve this remains unclear.

THE $4.3 BILLION MISTAKE

PEDIATRICS ◽  
1994 ◽  
Vol 94 (3) ◽  
pp. 290-290
Author(s):  
J. F. L.
Keyword(s):  
Scientific Method ◽  
Breast Implant ◽  
Breast Implants ◽  
Economic Incentive ◽  
Epidemiological Studies ◽  
Silicone Implants ◽  
Silicone Breast Implant ◽  
Contingency Fees ◽  
The Media ◽  
Set Up

Three recent epidemiological studies of purported links between breast implants and a variety of ailments, notably the skin hardening disease scleroderma, have concluded that the linkage simply cannot be established. Gee, that's nice to know. Better late than never. Too bad, though, that in our era the scientific method can't compete anymore with lawyers marauding after some $1 billion in contingency fees, politically correct mind-sets in the media, or Dr. Kessler's Food and Drug Administration. It's too bad, because as a result of the atmosphere of fright created by this triumvirate, nearly all companies withdrew from the silicone breast-implant market. Mastectomy patients, past and future, now face a destroyed market for silicone implants. It has to be understood that these plaintiffs' lawyers have a huge economic incentive in the outcome of such cases because they get an enormous percentage cut of any settlement. It is in their economic interest to make the stories of diseases related to silicone implants as lurid and horrible as possible, because it drives deep-pockets defendants toward settlements like the $4.3 billion pot set up by Dow Corning, Bristol-Myers, Baxter Labs, 3M, and others in this case. Only about 22 lawyers will be divvying up most of the $1 billion in contingency fees.

Localized morphea after breast implant for breast cancer: A case report

2018 ◽  
Vol 104 (6) ◽  
pp. NP25-NP28
Author(s):  
A Moretti ◽  
F Bianchi ◽  
IV Abbate ◽  
G Gherardi ◽  
M Bonavita ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Breast Implant ◽  
Connective Tissue Diseases ◽  
Breast Implants ◽  
Skin Lesions ◽  
Local Relapse ◽  
Cutaneous Metastasis ◽  
Silicone Implants ◽  
Clinical Report

Purpose: Early breast cancer follow-up guidelines for patients who underwent surgery suggest a regular and accurate clinical examination of the breast area, for an early identification of cutaneous or subcutaneous breast cancer relapse. Nonetheless, breast skin lesions arising in patients treated with mastectomy for breast cancer can be caused by several diseases. A series of diagnostic hypotheses should be considered, not only focusing on cutaneous metastasis, but also on dermatologic and systemic diseases. Case report: In February 2015, a 37-year-old patient underwent a right subcutaneous mastectomy for stage IIA breast cancer. Five months after beginning adjuvant chemotherapy, she noted hyperpigmentation and thickening of the skin on the right breast. Differential diagnosis included local relapse, skin infection, lymphoma, or primary cutaneous disease, and a skin biopsy was performed. The histopathologic specimen showed full-thickness sclerosis, with features of localized morphea. Therapy with clobetasol was prescribed, with progressive resolution of the thickness. The collaboration between many professionals in a multidisciplinary team (oncologist, dermatologist, plastic surgeon, and pathologist) was crucial to achieving the diagnosis. Conclusion: In the literature, some articles describe correlation between connective tissue diseases and silicone breast implants, but the pathogenetic mechanisms are unknown. We report a rare case of breast morphea after positioning a silicone implant in a patient who had undergone mastectomy. This clinical report represents an interesting model of multidisciplinary management of a patient with breast cancer who developed an uncommon dermatologic disease. Further studies are needed to clarify the association between silicone implants and breast morphea.

Symptomatic delayed seromas vs incidental findings on MR, and likelihood of BIA-ALCL in women with textured implants.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e20028-e20028
Author(s):  
Paola Ghione ◽  
Elizabeth J. Sutton ◽  
Qunying Hu ◽  
Natasha Galasso ◽  
Nivetha Ganesan ◽  
...  
Keyword(s):  
Median Time ◽  
Incidental Findings ◽  
Incidental Finding ◽  
Breast Implant ◽  
Breast Implants ◽  
Silicone Implants ◽  
Textured Surface ◽  
Asymptomatic Patients ◽  
Asymptomatic Women

e20028 Background: Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a subtype of ALCL, arises as a seroma in the space between the implant and the capsule, or as an adjacent mass. BIA-ALCL appears to be related to textured-surface implants, after 7-10 years of exposure. We conducted two large cohort studies. The 1st, a retrospective series (Sutton, 2019) assessed the incidental findings of masses or seromas in 1070 women with breast implants undergoing MR for FDA recommended screening for silent ruptures of silicone implants. Incidental finding of seromas or breast masses on MRI were found in 18/1070 (1.7%) women, of which 1/15 had BIA-ALCL, and was symptomatic at the time of MRI. The 2nd, a prospective study (Cordeiro, 2020) defined the incidence of BIA-ALCL (1/355) in a cohort of 3546 women with textured implants followed long term. Within this cohort, there were 28 clinically relevant delayed seromas (0.79%), 8 of which were BIA-ALCL (28.5%). We hypothesize that combining these databases will inform whether asymptomatic women with textured implants may benefit from MR to r/o BIA-ALCL. Methods: The two IRB approved databases were merged. Patients with incidental findings of seroma on MRI were identified. A majority of the MRIs in this merged cohort were performed to follow the FDA recommended screening for silent ruptures. We identified all clinically relevant late seromas sent to hematopathology to r/o BIA-ALCL by cross checking pathology reports containing the words “lymphoma” or “anaplastic” or “ALCL”. Results: 572 women were included in both studies: followed long term and received an MRI after a median time of 7.4 years after breast reconstruction. 8 of 572 women had an incidental finding of seroma on random MRI, and 2 had capsular masses. None of these 10 asymptomatic women have developed BIA-ALCL to date (median follow-up 9 years). 11 of 572 women had a symptomatic seroma or mass, 4 of which later developed BIA-ALCL, a fifth patient was found to have BIA-ALCL on a PET/CT + lymph node, despite being asymptomatic. Median time from last MR to lymphoma was 5 years (3-8 years). Conclusions: In this merged cohort of patients with textured breast implants, incidence of BIA-ALCL in patients with symptomatic late seromas is around 30%, while seromas found incidentally on MR of asymptomatic patients were negative for BIA-ALCL.

Imaging of breast implant and implant-associated complications: Capsular contracture and intra- or extracapsular rupture

2020 ◽  
Vol 76 (2) ◽  
pp. 221-231 ◽  
Author(s):  
M. Georgieva ◽  
S. Kammerer ◽  
L. Prantl ◽  
F. Jung ◽  
C. Stroszczynski ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Clinical Examination ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Breast Implants ◽  
Silicone Implants ◽  
Resonance Imaging ◽  
Early Complications ◽  
Pet Ct

BACKGROUND: In recent years, follow-up after breast reconstruction with silicone implants and the detection of complications have been relieved by the possibility of improved diagnostic methods. METHODS: Between January 2015 and December 2019 a total of 40 patients (29–84 years) with silicone implants were included in this retrospective study. The implants were examined clinically and with modern imaging: general ultrasound imaging (US), magnetic resonance imaging (MRI), high resolution computed tomography (CT) and positron emission tomography –computed tomography (PET-CT). If necessary, a histological/cytological sample was taken. The breast implants were assessed by three radiologists specialized in breast imaging. The grade of capsular contracture was classified according to the Baker classification. RESULTS: All 40 women obtained a clinical examination and an US diagnostic to identify early and more common complications such as implant folding and capsular fibrosis. Depending on the clinical examination and ultrasound findings additional MRI (n = 10), CT (n = 9) and/or PET-CT (n = 2) were performed. 16 patients had implants folding proven with US (n = 16), MRI (n = 6) and CT (n = 1). The grade of capsular fibrosis was determined according to the Baker classification. The following results were obtained in our study: 25 breast implants with Baker grade I and eleven breast implants with Baker grade II, both proven with US; one breast implants with Baker grade III and one breast implant with Baker grade IV, proven with US (n = 2), MRI (n = 1) and CT (n = 1). One patient had intracapsular rupture and one patient had extracapsular rupture, both detected on CT and surgically proven. No patient had a silicone accumulation in the lymph nodes. One patient had pathologically enlarged axillary lymph nodes, which were evaluated as inflammatory changes in PET-CT. Long-term complications such as the development of malignant breast tumors could not be observed. CONCLUSION: To detect early complications after breast implant surgery, a regular clinical examination is indispensable. Imaging methods complement each other and if they are used multimodal, it is easier to identify early complications. Modern diagnostic modalities like ultrasound and magnetic resonance imaging expand the spectrum and improve diagnostic safety.

Sign in / Sign up

Export Citation Format

Share Document