Silicone Leakage From Breast Implants and Its Association With Capsular Contracture in 657 Patients.

This article investigates the association between silicone leakage from breast implants and the risk of capsular contracture, a common complication characterized by fibrous capsule thickening and breast deformation. In a multicenter cross-sectional study of 657 patients undergoing implant revision after breast reconstruction or augmentation, silicone leakage into the fibrous capsule was quantified histopathologically and correlated with capsular contracture diagnosed by the Baker classification. The study found a significant dose-dependent relationship whereby even small amounts of silicone leakage from intact implants increased the risk of capsular contracture independently of implantation time and implant rupture. These findings suggest the importance of selecting implants with low silicone leakage rates, such as highly cohesive silicone implants, and support consideration of surgical removal of silicone-embedded capsule tissue during implant replacement to reduce contracture risk.