Liv Schollhammer^1,, Kira Lundin¹

The formation and consequences of capsular silicone granulomas related to breast implants are not well described in the literature but leakage of silicone is perceived to play an essential role. Studies have suggested rupture rates varying from 8-55% at year 10 after implantation. We describe two cases where women were referred to our department for removal of silicone breast implants due to rupture. At both surgeries, the patients presented with hard, brittle plaques on the inside of the fibrous capsule formed around the implants. A plaque was removed from the capsule of the first patient and histopathological examination confirmed it to be a calcified silicone granuloma. During surgery on the second patient, a similar plaque was excised and the sharp edges were seen to easily cut through the surface of the freshly removed implant. Procedural statistics from the American Society of Plastic Surgeons (ASPS) show a considerable increase in cosmetic breast augmentations performed, as well as a growing tendency for operations performed on younger patients. Consequently it is probable that an increasing number of patients in the future will need operation to change implants. With this commentary we wish to draw attention to the possible detrimental effect of calcified silicone granulomas on silicone implants when left in a breast after changing of implants. Further studies on the incidence and potential side effects of calcified silicone granulomas are needed.

breast augmentation, breast implants, cosmetic surgery, silicone granuloma, implant rupture