Scleroderma after silicone augmentation mammoplasty: report of a case

The development of connective tissue diseases in patients who have had silicone gel breast implants has not been previously described in Taiwan. Herein, we report a 44-year-old female patient who underwent a silicone gel breast implant approximately 10 years prior to the onset of scleroderma. She developed generalized sclerosis, severe defective esophageal clearance, and severe reduction of gas exchange with DLco 37% of predicted value. Immunologic tests revealed that the antinuclear antibody titer was 1:2,560 with speckled pattern and positive anti-Scl-70 antibody. In spite of prednisolone and D-penicillamine treatment, her condition deteriorated. However, following the removal of the prosthesis, short-term subjective and objective improvements in both skin lesions and pulmonary function were noted. It is important that plastic surgeons, rheumatologists, and dermatologists, as well as primary care physicians, be aware of the possible association of sclerosis with silicone gel breast implants.