Department of Plastic and Hand Surgery, University of Erlangen-Nürnberg, University Hospital, 91054 Erlangen, Germany.
Breast J. 2009 Sep-Oct;15(5):496-9. doi: 10.1111/j.1524-4741.2009.00765.x. Epub 2009 Jul 13.
Since the implementation and use of silicone implants in breast surgery the risks are published and discussed. Especially, the incidence of late silicone implant rupture and its potential risk to induce local siliconomas are still under discussion and not sufficiently evaluated. So far literature data offer no information of intrapulmonal or peripheral located cutaneous siliconomas because of systemic migration of silicone after breast augmentation. In light of silicones checkered history, and given the large and growing number of women who choose to undergo breast augmentation surgery each year, the presented clinical findings in our study are likely to be of interest to medical professionals, producers, and consumers alike. We present six female patients with an average age of 55 (+/-5) years with bilateral rupture of silicone implants after breast augmentation for aesthetic reasons. The average time after operation was 18 (+/-6) years. In five patients, we identified peripheral located cutaneous siliconomas and one patient suffered from an intrapulmonal siliconoma. The diagnosis of bilateral rupture of the silicone implants was performed preoperatively by MRI-scans. All five peripheral cutaneous siliconomas and the intrapulmonal siliconoma were validated by histopathologic analysis. Six female patients suffered from bilateral rupture of silicone implants after breast augmentation. In five patients, we identified peripheral located cutaneous siliconomas which were surgically excised. One patient suffered from an intrapulmonal siliconoma. In this unique case a lobectomy with resection of the pulmonal segment 10 had to be performed. Clinical findings of peripheral cutaneous and even intrapulmonary siliconomas after bilateral rupture of silicone breast implants indicate a systemic hematogen or lymphatic pathway of silicone. These findings suggest that it is mandatory to inform the patient about the potential risk of local siliconomas, but also about the potential risk of peripheral cutaneous or even intrapulmonary siliconomas caused by systemic hematogen or lymphatic pathways of silicone after silent implant failure.
自乳房手术中使用硅树脂植入物以来，其风险已被公布并讨论。特别是，硅树脂植入物晚期破裂的发生率及其潜在的诱发局部硅瘤的风险仍在讨论中，尚未得到充分评估。到目前为止，由于乳房增大后硅酮的全身迁移，文献数据并未提供肺内或周围皮肤硅瘤的信息。鉴于硅酮的曲折历史，以及每年有大量女性选择接受乳房增大手术，我们在研究中呈现的临床发现可能会引起医学专业人员、生产商和消费者的兴趣。我们介绍了 6 名平均年龄为 55（+/-5）岁的女性患者，她们因美容原因进行乳房增大手术后双侧硅树脂植入物破裂。手术平均时间为 18（+/-6）年。在 5 名患者中，我们发现了周围定位的皮肤硅瘤，1 名患者患有肺内硅瘤。术前通过 MRI 扫描诊断双侧硅树脂植入物破裂。所有 5 个周围皮肤硅瘤和肺内硅瘤均通过组织病理学分析得到证实。6 名女性患者因美容原因进行乳房增大手术后双侧硅树脂植入物破裂。在 5 名患者中，我们发现了周围定位的皮肤硅瘤，这些硅瘤已通过手术切除。1 名患者患有肺内硅瘤。在这种特殊情况下，必须进行肺叶切除术并切除第 10 段肺段。双侧硅树脂乳房植入物破裂后出现周围皮肤甚至肺内硅瘤的临床发现表明硅酮存在全身性血源或淋巴途径。这些发现表明，必须告知患者局部硅瘤的潜在风险，还必须告知患者由于硅酮的沉默植入物失败导致的全身血源或淋巴途径引起的周围皮肤甚至肺内硅瘤的潜在风险。
