Hi Lisa, In light of this women's history of implants and peri areolar
incisions a consideration may be leaking implants. With the pressure from
glandular growth and subsequently undrained milk (due to the incisions) it
is possible that a leak in the implant may have been induced. Depending on
the contents of the implants (I shouldn't think normal saline would be a
problem), if this had occurred, and there was also leakage of milk into the
interstitial tissues a heightened immune response may be the cause of the
symptoms she's experiencing. A currently held theory with mastitis is that
severe systemic symptoms suffered with mastitis are as a result of leaking
of the pro inflammatory cytokines present in milk (particularly TNF alpha,
Interleukins  1, 6, 8 & 12.) into the interstitium. These trigger the severe
inflammatory response we see. If there is silicone present a quite severe
inflammatory response may be initiated, perhaps explaining the rash.
This may be a bit far fetched, but if there is no response to conventional
treatment, may be a consideration.

Regards
Cathy Fetherston
Perth Western Australia

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