Learning Radiology xray montage

Free Silicone Injections


General Considerations

  • Commonly used for breast augmentation in the ‘50s and ‘60s
  • It was stopped because of safety concerns and it was ineffective
  • Eventually, banned by the U.S. Food and Drug Administration in 1992
  • However, it may still be found in older patients and immigrants, especially from South America and Asia
  • Complications are common and include inflammation with
    • Formation of silicone granulomas
    • Fibrosis
    • Lymphadenopathy

Clinical Findings

  • Silicone granulomas are clinically palpable
    • Diffuse nodularity and hard lumps, making manual breast examination difficult

Imaging Findings

  • On mammography, free silicone demonstrates multiple, very dense and lobulated masses throughout the breast with or without peripheral calcifications
  • The masses can cause distortion of the breast parenchyma and obscure visualization of a small breast cancer
  • Extremely dense lymph nodes may also be present
  • Sonographic and MRI findings are similar to those of extracapsular implant ruptures
    • But, findings are scattered throughout the breasts without the presence of an envelope or fibrous capsule
  • MRI, especially with fat and water suppression technique, will afford optimal visualization of free silicone and should permit differentiation of free silicone from a breast neoplasm

Free Silicone Injections

Free Silicone Injections, Breast. Craniocaudad views of both breasts show innumerable very dense and lobulated masses throughout both breasts

Challenges in Mammography: Part 2, Multimodality Review of Breast Augmentation—Imaging Findings and Complications. S Venkataraman, N Hines, and P Slanetz. AJR. December 2011, Volume 197, Number 6