Silicone implants have been used in plastic, aesthetic and reconstructive breast surgery since the 1960’s and have long been considered as biologically inert and harmless.
The safety of breast implants has been extensively investigated in North America specifically related to concerns related to links with connective tissue diseases such as cancer, systemic lupus erythematosis, rheumatoid arthritis, scleroderma.
The FDA Views
Although the FDA has shown that silicone does not cause breast implant sickness, cancer or major diseases, no-one can deny that some individuals do have allergies to silicone and silicone-related products and that there are patients who develop non-specific symptoms. The FDA has shown that there is a 1-2% link to autoimmune symptoms/conditions but this is not significantly higher than the general population.
Social Views on Breast Implant Sickness
Silicone sickness, silicone sickness syndrome, breast implant sickness are terms used throughout social media by patients describing chronic fatigue, joint pain, and muscle soreness.
Crystal’s Hefner was one high profile celebrity in 2016 that wrote: “My Breast Implants Slowly Poisoned Me. Intolerance to foods and beverages, unexplained back pain, constant neck and shoulder pain, cognitive dysfunction (brain fog, memory loss), stunted hair growth, incapacitating fatigue, burning bladder pain, low immunity, recurring infections and problems with my thyroid and adrenals.”
Past Statistics
The bizarre collection of symptoms has previously been described in Israel in 2015 as autoimmune/inflammatory syndrome induced by adjuvant—ASIA (Ref 1).
Those believed to be most at risk include:-
- Those with prior documented autoimmune reactions to an adjuvant ie such as vaccination or implant.
- Those with established autoimmune conditions such as rheumatoid arthritis, diabetes etc
- 75% of women had a history of allergic conditions such as eczema, hay fever, pollen and dust allergy, drug allergy, rubber or latex allergy.
- Those with a family history of autoimmune diseases such as rheumatoid arthritis, multiple sclerosis, systemic lupus, etc.
In addition to the genetic predisposition, environmental factors have also been linked to autoimmunity. Obesity and smoking are both examples of environmental triggers that contribute to both initiation and progression of autoimmune disorders.
Danish Breast Implant Sickness Study
Interestingly however a long term follow up study of Danish women who had submammry smooth silicone breast implants for an average of 19 years found no consistent differences in the seroprevalences of antinuclear antibodies or other autoantibodies ie markers for rheumatoid arthritis. The authors evaluated long-term symptoms and conditions and medication use among 190 Danish women with cosmetic silicone breast implants compared with 186 women who had undergone breast reduction surgery and with 149 women from the general population. They concluded that their breast implants did not appear to be associated with other symptoms, diseases, or autoimmune reactivity. There was however a self reported increase in hormonal replacement therapy, psychotropic medications, with an emphasis on antidepressants amongst those women with breast implants.
Concluded Evidence of Breast Implant Sickness
For those that have developed unusual symptoms that they associate with breast implant sickness / silicone sick syndrome there is no guarantee that removing breast implants will resolve the symptoms. There is also no evidence that en bloc removal of the capsules with removal of the breast implants will resolve symptoms.
Mr Ross offers en bloc removal of implants and will always send the breast implant capsule for pathological analysis so that patients can be given additional reassurance. Patients however need to be aware of the pros and cons and be empowered to make the decision to proceed with removal or not.
References
- Goren I, Segal G, Shoenfeld Y. Autoimmune/inflammatory syndrome induced by adjuvant (ASIA) evolution after silicone implants. Whois at risk? Clin Rheumatol. 2015 Oct;34(10):1661-6. Epub 2015 Apr 16.
- Breiting VB, Holmich, LR, Brandt B, Long-term health status of Danish women with silicone breast implants. Plastic and Reconstructive Surgery. 2004; 114: 217-226.
