Increase of immunologically relevant parameters in correlation with Baker classification in breast implant recipients

A variety of studies have suggested a possible immune reaction to silicone implants, although an increased frequency of rheumatic disorders among implant recipients could not be established. Several immunologically relevant humoral parameters were investigated in 239 breast implant recipients. The following parameters were determined: immunoglobulin G and M, complement C3 and C4, rheumatoid factor, C-reactive protein, antinuclear antibodies, antimitochondrial antibodies, and antithyroglobulin and antimicrosomal antibodies of the thyroid gland. Levels of complement C3 were elevated in 42.5% of the patients. No difference could be observed between silicone gel-filled and saline-filled implant recipients. Complement C4 was increased in 21.3% of the patients and a parallel relationship was observed between elevated C4 and C3 levels (p < 0.0015). In 28% of the patients, the antithyroglobulin titer was elevated > 200 U/ml. No difference was found between silicone gel-filled and saline-filled implant recipients. Elevation of antimicrosomal antibodies existed in 14.3% of the patients and was correlated significantly with antithyroglobulin antibodies (p < 0.0347). In accordance with the classification developed by Baker, we observed a significant correlation between capsule fibrosis types Baker I and II, and elevated C3 values (p < 0.0004) in silicone gel-filled but not in saline-filled implant recipients. Additionally, a correlation was found between increased antithyroglobulin titers (< 200 U/ml) and capsule fibrosis types Baker I and II (p < 0.0001) in this group. In the study presented here, an increase of several humoral parameters could be demonstrated in breast implant recipients, although we failed to correlate these findings with any clinical symptoms.