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Silicone breast implants and autoimmune rheumatic diseases: myth or reality
Jan Willem Cohen Tervaert1, Maartje J Colaris, René R van der Hulst
1aDepartment of Immunology, Maastricht University bDepartment of Plastic Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.
Purpose Of Review:
In the present review, recent findings regarding silicone breast implants (SBIs) complicated by rheumatic autoimmune diseases are described.
Recent Findings:
Despite changes in the principal constituents of the silicone implants during the past 50 years, silicone remained an adjuvant that may 'bleed' and subsequently may be a chronic stimulus to the immune system resulting in similar clinical manifestations as 50 years ago. Silicones are spread throughout the body and can be detected in tissues and the central nervous system. Autoimmune/inflammatory syndrome by adjuvants (ASIA), allergies, autoimmune diseases, immune deficiencies and lymphomas occur in patients with SBIs. There is a need for adequately adjusted epidemiological studies to ascertain the frequency of these diseases. Explantation of the breast implants, however, should be advised to patients with complaints, as 60-80% of patients show an amelioration of the signs and symptoms after explantation.
Summary:
SBIs are associated in a proportion of patients with complaints such as fatigue, cognitive impairment, arthralgias, myalgias, pyrexia, dry eyes and dry mouth. Silicones can migrate from the implant through the body and can induce a chronic inflammatory process. Explantation of SBI results in the majority of patients in an amelioration of the symptoms.