Severe migratory granulomatous reactions to silicone gel in 3 patients

In humans implanted with silicone gel breast prostheses, a mild foreign bod y response results in the formation of a collagenous capsule around the pro sthesis. Although many such patients may show evidence of a microscopic gra nulomatous foreign body reaction upon examination of capsular material at e xplantation of a prosthesis, it is unusual to have large, palpable granulom as, even in the presence of rupture or leakage. Rare patients have had seve re local inflammation and complications resulting from silicone migration t o the axilla, arm, or abdominal wall. We describe 3 patients who had deform ing granulomas after implant rupture, along with other consequences of sili cone gel migrating down the upper extremity. Silicone gel, once it leaves t he implant, is not biologically inert and in some persons can elicit profou nd pathologic responses.