Late complications associated with silicone breast implants

In recent years, the number of breast implant removal surgeries has increased due to concerns about silicone implant-related pathologies, aesthetic dissatisfaction, and late complications in 20–30% of cases. Local late complications include capsular contracture, implant ruptures, silicone granulomas and seromas, anaplastic large cell lymphoma and breast implant-associated squamous cell carcinoma. Systemic complications include silicone implant disease and adjuvant-induced autoimmune/inflammatory syndrome. Silicon microparticles from ruptured implants can spread through lymphatic and blood vessels to axillary, subclavian, cervical, and other lymph nodes, as well as to distant organs and tissues. This review presents data over the past five years on possible causes, clinical presentation, diagnostic methods and treatment of these complications. Specific symptoms of this pathology can be identified using ultrasound, computed tomography, or magnetic resonance imaging. A definitive diagnosis of silicone lymphadenopathy or granuloma is based on fine-needle aspiration, punch biopsy, or intraoperative biopsy. Migration of free silicone is important in differential diagnosis of patients after mastectomy and implant reconstruction. In case of implant rupture, explantation is necessary with or without replacement. Treatment of silicone lymphadenopathy or silicone granulomas may include follow-up, corticosteroids for immunosuppression or surgery. Potential impact of silicone gel leakage, its migration and systemic symptoms are underestimated and require further research, improved diagnosis and treatment.