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Before and after bilateral mastectomies and DIEP flap breast reconstructions in a 34 year old woman. Instead of breast cancer as the reason for needing mastectomies, in this case it was due to free silicone extrusion coming out of the upper pole of her breasts. Several years before, in an attempt to augment her breasts by “a friend of a friend”, she underwent illegal off-label injection of industrial silicone into her breasts in someone’s garage (!!).

Unfortunately, the injected non-medical grade material acted as a toxin and an irritant inside the body, causing an immense granulomatous reaction inside her breasts. Her body eventually began extruding this industrial substance, with the silicone and reactive scar tissue coming out through her skin. In retrospect, a breast augmentation with FDA-approved silicone gel breast implants would have been a much safer, reliable and intelligent choice…

She required a bilateral mastectomy with excision of the involved skin to fully remove all the foreign material that had been injected into her body. Thankfully, she had enough lower abdominal healthy skin and fat to reconstruct her breasts. Breast implants would not have been an ideal reconstructive solution in her particular situation due to existing contamination and possible infection.

Bilateral DIEP flaps reconstructed her breasts. The skin that required removal at the top of her breasts was replaced with a patch of skin from her belly. Follow up photos are shown a year after surgery with scars that are still maturing and fading.

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*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.

Dr Karen Horton