Surgical Management of Severe Bilateral Breast Silicone Granulomatosis: A Case Report

Silicone granulomatosis is a chronic inflammatory response induced by the introduction of silicone into soft tissue, typically occurring during cosmetic or reconstructive procedures. Despite its well-established association with silicone injections, managing silicone granulomatosis poses significant challenges, necessitating a multidisciplinary approach to achieve favorable patient outcomes. Treatment involves a spectrum of medical modalities alongside surgical interventions, with the extent of surgical management varying based on disease severity. However, recurrence remains a concern, particularly in cases of extensive tissue dissemination following incomplete excision. We present the case of a 46-year-old woman with severe bilateral silicone granulomatosis of the breast treated using a multi-step surgical approach. Our strategy encompassed bilateral mastectomy, bilateral autologous breast reconstruction utilizing the latissimus dorsi pedicle flap technique, tissue expander placement, silicone gel implant insertion, and bilateral nipple reconstruction. This comprehensive approach aimed not only to eradicate granulomatous tissue but also to reconstruct and restore the affected breasts, thereby enhancing both functional and aesthetic outcomes.