Clinical features of local breast phenomena in 300 symptomatic recipients of silicone gel-filled breast implants

Aims: To define the subjective and objective breast area problems encountered in clinically symptomatic recipients of silicone gel-filled breast implants. Methods: Three hundred patients who became systemically ill following insertion of silicone gel-filled breast implants were examined. The mean age at the time of implantation was 33 years, and the average silicone gel device exposure spanned 12 3/4 years. Results: Two hundred and ninety-seven patients experienced multiple local breast phenomena including itching, rash, burning, numbness, coldness, pain, hardening, bogginess, displacement, puckering, sagging, nodularity, slow shrinkage, or overt rupture. A key clinical event was failure of the capsule which occurred on average Jive years from the time of initial implantation, which in turn was the forerunner of subsequent rupture. Rupture occurred in 214 cases (71%) at the average rate of 5% per year preceded systemic disease onset in only nine patients (3%), and occurred as a single local event in only four patients (1%). Conclusions: In this cohort of silicone gel breast implant recipients, clinically apparent local breast phenomena exhibited chronological order to each other and manifested an integral relationship to systemic disease development and progression.