Leader Pathology of silicone leakage from breast implants

Silicone breast prostheses have been widely used for several decades. Until recently, about 150 000 women received these implants annually in the United States—80% for breast augmentation and the others almost exclusively for reconstruction after cancer surgery. There is little doubt about the beneficial psychological eVects of breast implants, but there is increasing awareness of alleged adverse eVects of implants containing silicone. These mainly concern local reactions to silicone “sweating” from the implants (gel bleed) and frank rupture, but silicone leakage has also been associated with locoregional eVects such as histiocytic necrotising lymphadenitis and with systemic disorders such as autoimmune and connective tissue diseases. These side eVects have led to discussion about whether silicone breast implants should be removed from the market. 2 In this leader we review the specific pathological locoregional aspects of (leakage from) silicone breast implants. It is beyond the scope of this paper to discuss the pathology of silicone leakage in other parts of the body.