Hirmand H, Hoffman L A, Smith J P
Division of Plastic and Reconstructive Surgery, New York Hospital-Cornell Medical Center, NY 10021.
Ann Plast Surg. 1994 Jun;32(6):645-7. doi: 10.1097/00000637-199406000-00015.
We present a case report of silicone particles found in the pleural fluid of a patient 20 years after bilateral augmentation mammaplasty with silicone-gel implants. The patient's history is notable for bilateral replacements of implants and multiple closed capsulotomies several years subsequent to the original augmentation procedure. A ruptured left implant was found in 1991 when she first experienced pain in the upper back. A left pleural effusion developed subsequently. Analysis of the pleural effusion fluid by scanning electron microscopy suggested the presence of silicone. All laboratory results were normal, and the effusion did not recur after thoracentesis. The patient has been under close follow-up, and further pulmonary complications or other symptoms have not developed. This case report demonstrates the potential for silicone migration to the pleura and the possibility of subsequent pulmonary complications, such as pleural effusion.
我们报告一例患者,在双侧植入硅胶凝胶假体进行隆乳手术20年后,其胸腔积液中发现了硅胶颗粒。该患者的病史值得注意,在最初的隆乳手术后几年,进行了双侧假体置换和多次闭合性包膜切开术。1991年,当她首次出现上背部疼痛时,发现左侧假体破裂。随后出现左侧胸腔积液。通过扫描电子显微镜对胸腔积液进行分析,提示存在硅胶。所有实验室检查结果均正常,胸腔穿刺术后积液未复发。该患者一直在密切随访中,未出现进一步的肺部并发症或其他症状。本病例报告证明了硅胶迁移至胸膜的可能性以及随后发生肺部并发症(如胸腔积液)的可能性。