Silicone Breast Implant—Associated Scarring Dystrophy of the Arm

Background: Breast implants have been known to rupture after trauma or closed capsulotomy with spread of the gel down the arm or abdominal wall. Nodular foreign-body granulomatous reactions have been reported in these cases. We report the unique occurrence of significant overlying scarring and ulceration following silicone gel migration down the affected arm. Observations: A 47-year-old woman experienced rupture of her right silicone gel implant with migration of the silicone down her arm 10 years before our examination. Skin changes with atrophic hidebound scarring and ulceration slowly progressed over the last 7 years. Radiographs and magnetic resonance imaging scans demonstrated material consistent with silicone in the soft tissues. Conclusions: Silicone is not an inert substance and can rarely result in devastating local tissue destruction where migration has occurred. The possibility of significant silicone gel migration should be considered during evaluation of patients with ruptured implants. (Arch Dermatol. 1995;131:54-56)