Augmentation mammoplasty has become a widely employed cosmetic procedure. In the United States an estimated 2 million women have received breast implants.1 Most of the implants contain silicone gel as the filling material. The gel used in the implant is produced from silica, reduced to form silicone, which is reacted with methylchloride and polymerized to form stable polydimethylsiloxane. Silicone has been extensively employed because of its ideal physical properties and the general perception based on published evidence suggesting that medical-grade silicone polymer is chemically and biologically inert.2-6 The enormous popularity of silicone mammoplasty, and its rapidly increasing use, render it timely to consider the possible long-term adverse effects of silicone.
Over the past two decades, a variety of complications associated with silicone mammary prostheses, including local infection, pain, and contracture of the fibrous capsule that forms around the implant, have been recognized.7 A disturbingly frequent observation is