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Staged implant based reconstruction of free silicone injected chest wall tissue in a transgender female patient - a case report
Joseph C Easton MD
Liann Casey MD
W John Kitzmiller MD
University of Cincinnati Medical Center
2024-01-14
Presenter: Joseph C Easton MD
Affidavit:
Yes
Director Name: Ann Schwentker MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Free silicone injections have been established to have severe medical side effects and unsatisfactory aesthetic results. This case report discusses the treatment and reconstruction of a transgender female patient who previously underwent silicone injections into her subcutaneous and intra-muscular chest wall. JS is a 52 year old transgender female that underwent roughly 300 cc of free silicone injections into her chest wall over ten years prior to presentation. She presented to our institution with bothersome subdermal granulomas and an unacceptable aesthetic result in the setting of gender dysphoria. Her reconstruction was approached in a staged manner. In one surgical stage she underwent subcutaneous mastectomies through inframammary incisions for the purpose of completely debulking all subdermal, subcutaneous and intra-muscular silicone granulomas. Three months later she returned for a second surgical stage at which time low profile 400 cc silicone implants were placed in a subpectoral pocket with an inferior acellular dermal matrix sling. At 3 months post-operative follow-up from the second stage she has had no surgical complications, is relieved of her bothersome silicone granulomas, and is subjectively very satisfied with her aesthetic result.
