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, 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