Complications of Silicone Gel Migration Affecting Peripheral Nerves

Abstract

At present, there is extensive use of silicone implants and injections for breast and gluteal augmentation and other cosmetic procedures. Despite their popularity, these procedures are not free of risk or complications. Since their introduction for use in mammoplasty, many complications have been described, related to the surgical technique, infections, postoperative hematomas, and contractures of surrounding tissue. Systemic complications also have been reported when silicone gel is used as a liquid injection or in an elastomer shell. Connective tissue diseases—triggered by an autoimmune response to the synthetic material, eliciting a foreign body reaction associated with granulomatous inflammation, fibrosis, and migration to the lymph nodes—are examples of systemic involvement. Virtually all tissues can be affected by this immune response, so peripheral nerves are not excluded. However, at this time, information about this topic is limited, as are specific treatment protocols. The objectives of this chapter are to review the more frequent types of peripheral neuropathies and to review the path from diagnosis to management in those patients in whom silicone migration has affected the peripheral nervous system.