title: Complications of Poly Implant Prothèse breast implants: the current discussion.
abstract: Against the background of the current discussion about Poly Implant Prothèse (PIP, Seyne-sur-mer, France) breast implants, we want to present a case demonstrating the complications such as implant rupture, silicone dissemination and level III silicone lymphadenopathy. A 29-year-old woman with cosmetic breast augmentation with PIP implants 5 years previously showed a sensitive swelling in her right axilla and neck region. All tests to detect an infectious or lymphomatous lymphadenopathy were negative. After ultrasound and MRI, rupture of the right implant was assumed and multiple pathologically enlarged lymph nodes up to supraclavicular region were shown. An excision biopsy of one axillary lymph node was performed; the histological examination detected a strong silicone lymphadenopathy. Surgical removal of both implants as well as capsulectomy was performed and 14 axillary lymph nodes up to level II were resected. Histologic evaluation confirmed the previous results. Our case underlines the actual discussion concerning increased rupture rate and massive silicone lymphadenopathy by PIP implants. The Agence Francaise de Sécurité Sanitaire des Produits de Santé (AFSSAPS) recommends clinical and ultrasound examination every 6 months for women with PIP implants. Any rupture, suspected rupture or leakage of prosthesis should lead to its explantation as well as that of the contralateral implant. In cases of unusual signs of inflammation, histological and immunohistochemical samples are to be taken.
authors.affiliation: Department of Hand, Plastic and Reconstructive Surgery, Burn Care Unit, University of Heidelberg, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen, Germany. lkolios@bgu-ludwigshafen.de
authors.forename: Leila
authors.initials: L
authors.lastname: Kolios
authors.forename: Christoph
authors.initials: C
authors.lastname: Hirche
authors.forename: Alexander
authors.initials: A
authors.lastname: Spiethoff
authors.forename: Adrien
authors.initials: A
authors.lastname: Daigeler
authors.forename: Marcus
authors.initials: M
authors.lastname: Lehnhardt
mesh_terms: D000328:Adult; D001365:Axilla; D001706:Biopsy; D019928:Breast Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D018427:Breast Implants; D020878:Device Removal; D005260:Female; D005549:Foreign-Body Reaction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D020034:Silicone Gels; D016896:Treatment Outcome
chemical_list: D020034:Silicone Gels