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48 great number of files were available, we would have been able to subdivide our implant group by type of implant. Research Directions Future researchers may find it productive to continue to explore neuropsychological deficits and silicone gel breast implants. The HRNB seemed especially well suited to this type of research, as it is a standard battery that is commonly used by neuropsychologists. Additional measures of malingering and motivation may be useful, due to the litigation surrounding breast implants. It may be interesting to compare the performance of patients involved in litigation and patients not involved in litigation. Future research to replicate our results would be beneficial, as this is the first study of this kind using a sufficient sample size. One area of future research that may help to document the CNS deficits associated with silicone adjuvant disease involves the children of implant patients. Some physicians are currently recommending explantation for implant patients contemplating pregnancy, because silicone has been observed in breast milk, and to cross the placental barrier (Lewy, 1994). No studies exist that explore pediatric CNS difficulties related to prenatal silicone exposure, and/or silicone transmitted through nursing. As medical recommendations are being made for pediatric silicone
