Silicone migration to the pleural space associated with silicone-gel augmentation mammaplasty

We present a case report of silicone particles found in the pleural fluid of a patient 20 years after bilateral augmentation mammaplasty with silicone-gel implants. The patient's history is notable for bilateral replacements of implants and multiple closed capsulotomies several years subsequent to the original augmentation procedure. A ruptured left implant was found in 1991 when she first experienced pain in the upper back. A left pleural effusion developed subsequently. Analysis of the pleural effusion fluid by scanning electron microscopy suggested the presence of silicone. All laboratory results were normal, and the effusion did not recur after thoracentesis. The patient has been under close follow-up, and further pulmonary complications or other symptoms have not developed. This case report demonstrates the potential for silicone migration to the pleura and the possibility of subsequent pulmonary complications, such as pleural effusion.