American Society of Plastic Surgeons
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Anna P
2 years ago

Bilateral mastectomy after complication using filler injection.


I am a 61 yo and I had done breast augmentation in Eastern Europe around 8 years ago using filler injections. Now I have complications (lumps, pain, etc). I was offered 2 different strategies- filler removal or mastectomy with breast reconstruction. I cannot decide which one is better for me. I am also post-hysterectomy (uterine sarcoma).

Procedure: Breast Implant Removal
Location: Chicago, IL

Replies 6

Peter Henderson
ASPS Surgeon
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Thanks for sharing your story. Must be a difficult situation to be in. As someone who helps a lot of women who have had foreign body injections into the breasts, and have tried everything from minimal surgery (try to remove just targeted areas) to more aggressive surgery (near-total mastectomy), I am increasingly confident that many women would be well-served by having the more aggressive approach. Our ability to reconstruct after total mastectomy is very good (especially when using your own tissue, which avoids the need for another, albeit safer, foreign body such as in intact implant), and the degree of benefit that can be obtained from a limited approach is always underwhelming. It is certainly a major decision, and I encourage you to fully discuss with multiple surgeons before settling on a course, but all things being equal I would not shy away from the more aggressive approach. Hope this is helpful, and good luck!

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Samir Shureih

Based on a question on the internet without the benefit of IN person examination and consults with your oncologists regarding uterine sarcoma.

You need to deal with the most urgent issue the uterine sarcoma first.

Then Not knowing what filler was injected in the breast in Eastern Europe, I would do an MRI the n decide on on total mastectomy. Reconstruction would be considered after consultations with your oncologist for possible breast reconstruction. ( many options are available) if you are a candidate.

Would have the original slides or the specimen reviewed by another pathologist of my choice to review and see if there is any foreign material in the specimen, then decide on total body MRI or pet Scan based on consultation with the oncologist.

Tis more an oncology question than a plastic surgery question.

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Norman Bakshandeh
ASPS Surgeon

A partial or localized removal here will not work well because the injections are randomly placed. A near total or removal of most of the breast with the injected silicone with a immediate reconstruction will be the best option. This is something that I do frequently for breast cancer treatment already

Alfred Antonetti
ASPS Surgeon

I have no idea what you had injected but suspect it was liquid silicone. This causes a lot of lumps that can be painful and can be confused with cancer. You have 3 choices: 1) Stay as you are 2) have the damaged tissue removed possibly with a mastectomy, without reconstruction or 3) have the removal with reconstruction. All three have advantages and disadvantages that need to be discussed in person with your own board certifies plastic surgeon. Go back and ask more questions. You were given sound advice.

Rahul Vemula
ASPS Surgeon
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So sorry to hear of your situation. This is indeed a difficult situation. I have treated patients who are in your situation.

A couple of things to keep in mind

- need to find out exactly the filler that was put in was. ( This may be very difficult)

- Usually when these fillers are put in, they also inject right underneath the skin, the breast tissue and the muscle. It will be impossible to remove every bit of the filler no matter which option you choose the mastectomy or an attempt to remove a majority of the filler. Most likely scenario is that you will always have some of this material left in your body.

As regard to mastectomy vs removal of the filler, without examining you, and without looking at imaging such as a mammogram and an MRI, it is impossible to tell what would be the best option for you. Please meet with a board certified plastic surgeon as well as breast surgeon to see which would be the best option in your situation.


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