How safe are silicone breast implants?

The Food and Drug Administration's recent decision to limit the use of silicone gel breast implants was surrounded by a great deal of misleading information in the popular press. This article outlines the most relevant information available in the literature on the most often raised safety issues, including the carcinogenicity of silicone, speculation on a possible connection between silicone and autoimmune disease, the significance of gel bleed, and the effect of implants on mammography. In this attempt to better educate primary care physicians, we explain what is known about silicone gel breast implants so physicians can more wisely counsel their patients, who may be needlessly frightened by inaccuracies they have heard.