Breast reconstruction with TRAM flap after subcutaneous mastectomy for injected material (siliconoma)

Many patients throughout the world have had breast augmentation using injec table materials. In the Far East, an adulterated impure silicone has been u sed by non-medical persons and unlicensed 'cosmetic surgeons' as well as by licensed physicians. The injected material usually causes a granulomatous reaction, tenderness, erythema, pain or discomfort and even skin necrosis. Eventually, the injected breast becomes very hard and develops a distorted contour. Previous treatment was by subcutaneous mastectomy with immediate o r delayed reconstruction using a silicone prosthesis. The results of this w ere often unsatisfactory. We obtained more satisfactory results in 11 patie nts who had the siliconoma removed by subcutaneous mastectomy and the breas t reconstructed with a de-epithelialised TRAM flap. (C) 2001 The British As sociation of Plastic Surgeons.