Aesthet Surg J. 2024 Oct 15;44(11):1167-1175. doi: 10.1093/asj/sjae113.
Silicone implants are by far the most widely used implant globally for breast augmentation. Despite technological advancements, complications persist, with silicone lymphadenopathy (siliconoma) being a noteworthy concern. This phenomenon has been inadequately addressed in the existing literature.
The aim of this study was to characterize axillary siliconomas and identify potential risk factors to help reduce their occurrence.
The authors conducted a retrospective observational cross-sectional study spanning between 2011 and 2021 at the Shamir Assaf Harofeh Medical Center, Israel. Preoperative ultrasound examination was conducted, categorizing patients into those with siliconomas and those without.
A total of 614 women (1209 breasts) met the inclusion criteria. The incidence of siliconomas was 13.6% (165 breasts). In univariate analysis, older age (47 years vs 43 years, P < .001), older implant age (12.2 years vs 11 years, P = .026), ruptured implants (59.4% vs 17.7%, P < .001), subpectoral placement (P = .019), severe capsular contracture, and the use of Mentor implants (Irvine, CA; P = .007) and Poly Implant Prothèse implants (PIP; La Seyne-sur-Mer, France; P = .001) correlated significantly with the presence of siliconomas. In a multivariate analysis, implant rupture (odds ratio [OR] = 6.342), and implant manufacturer-Mentor (OR = 3.047) and PIP (OR = 3.475)-were identified as independent risk factors associated with a higher incidence of siliconomas. Severe capsular contracture was also associated with a higher incidence of siliconomas (OR = 1.65).
Surgeons should inform candidates about the potential risk of silicone migration. Patients with ruptured implants, significant capsular contracture, and Mentor and PIP implants face an increased risk for developing siliconomas. Closer monitoring for the detection of siliconomas in the axilla for these patients is advisable, and potential prophylactic replacement or removal of implants may be warranted to mitigate siliconoma risk.
硅酮植入物是目前全球应用最广泛的乳房隆乳植入物。尽管技术不断进步，但仍存在并发症，硅酮淋巴结病（硅瘤）是一个值得关注的问题。然而，现有文献对这一现象的描述并不充分。
本研究旨在对腋窝硅瘤进行特征分析，并确定潜在的风险因素，以帮助降低其发生率。
研究人员在以色列 Shamir Assaf Harofeh 医疗中心进行了一项回顾性观察性横断面研究，时间跨度为 2011 年至 2021 年。对所有患者进行术前超声检查，并将其分为硅瘤组和非硅瘤组。
共纳入 614 名女性（1209 侧乳房）。硅瘤的发生率为 13.6%（165 侧乳房）。单因素分析显示，年龄较大（47 岁比 43 岁，P <.001）、植入物较老（12.2 年比 11 年，P =.026）、破裂的植入物（59.4%比 17.7%，P <.001）、胸肌下植入（P =.019）、严重的包膜挛缩、使用 Mentor 植入物（加利福尼亚州欧文；P =.007）和 Poly Implant Prothèse 植入物（法国拉塞内尔；P =.001）与硅瘤的存在显著相关。多因素分析显示，植入物破裂（比值比[OR] = 6.342）和植入物制造商-Mentor（OR = 3.047）和 PIP（OR = 3.475）是与硅瘤发生率较高相关的独立危险因素。严重的包膜挛缩也与硅瘤的发生率较高相关（OR = 1.65）。
外科医生应告知患者潜在的硅酮迁移风险。破裂的植入物、严重的包膜挛缩、以及使用 Mentor 和 PIP 植入物的患者发生硅瘤的风险增加。对于这些患者，应密切监测腋窝硅瘤的发生，并可能需要预防性更换或取出植入物以降低硅瘤风险。
