Lu-Jean Feng, M.D.
Medical Director, Founder Board-Certified Plastic and Reconstructive Surgeon
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Dr. Lu-Jean Feng has performed extensive research on silicone lymphadenopathy over the last 20 years as a result of breast augmentation. As a result of this research, she has published a peer-reviewed paper with scientists from the Armed Forces Institute of Pathology in Washington, D.C. as well as from Case Western Reserve University in Cleveland. The study concluded that silicone in the lymph nodes can be diagnosed by ultrasound and localized by needle localization for precise removal. The polyurethane covered gel filled breast implants are associated with extensive silicone lymphadenopathy in the axilla, retropectoral, internal mammary, and sometimes neck nodes, but never in nodes below the diaphragm. The saline implants are never associated with silicone lymphadenopathy. Ruptured gel implants are only sometimes associated with silicone lymphadenopathy.
Silicone-laden lymph nodes, if they need to be removed, should only be removed after needle localization by a radiologist experienced with the technique. Dr. Feng has removed many silicone laden lymph nodes after needle localization in the past, but experience has shown that the removal makes little difference in patient’s recovery from implant illness. In addition, there are always risks of lymphedema of the arm, numbness in the arm, and seroma in the axilla. If a lymph node is to be removed, the silicone in the lymph node first has to be detected by ultrasound, which has a very specific signal.
According to Dr. Feng, the majority of silicone that she sees in lymph nodes is very small and not always accessible. Silicone laden lymph nodes could be located behind the ribs and close to the lungs. The only way to access these lymph nodes is to remove a portion of the rib. Some silicone laden lymph nodes are located very high up in the chest near the axillary vessels.
As Dr. Feng states in her webinar BI:II, “Yes, you can remove the lymph nodes, but which ones are you going to take? Are you going to take them all or are you going to take a few? If the lymph node is enlarged, if the lymph node is painful, if the lymph nodes can be localized, then these are all the conditions in which you could take out the lymph node. Otherwise if it is too small, too inaccessible, you can’t get to it. The most important thing is how it got there. It is more important to remove the implant and capsules than to remove the secondary effect of the implantation.”