Surgical Management of Severe Bilateral Breast Silicone Granulomatosis: A Case Report

TL;DR

A 46-year-old woman with severe silicone granulomatosis in both breasts underwent a multi-step surgical treatment to remove the affected tissue and reconstruct her breasts.

Contribution

This case report presents a comprehensive surgical strategy for managing severe bilateral silicone granulomatosis.

Findings

A multi-step surgical approach was used to treat severe bilateral silicone granulomatosis in a 46-year-old woman.

The treatment included bilateral mastectomy, tissue expander placement, and breast reconstruction using the latissimus dorsi pedicle flap technique.

The approach aimed to remove granulomatous tissue and restore both function and aesthetics in the affected breasts.

Abstract

Silicone granulomatosis is a chronic inflammatory response induced by the introduction of silicone into soft tissue, typically occurring during cosmetic or reconstructive procedures. Despite its well-established association with silicone injections, managing silicone granulomatosis poses significant challenges, necessitating a multidisciplinary approach to achieve favorable patient outcomes. Treatment involves a spectrum of medical modalities alongside surgical interventions, with the extent of surgical management varying based on disease severity. However, recurrence remains a concern, particularly in cases of extensive tissue dissemination following incomplete excision. We present the case of a 46-year-old woman with severe bilateral silicone granulomatosis of the breast treated using a multi-step surgical approach. Our strategy encompassed bilateral mastectomy, bilateral autologous breast reconstruction utilizing the latissimus dorsi pedicle flap technique, tissue expander placement, silicone gel implant insertion, and bilateral nipple reconstruction. This comprehensive approach aimed not only to eradicate granulomatous tissue but also to reconstruct and restore the affected breasts, thereby enhancing both functional and aesthetic outcomes.

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