Fundamentals of Breast Implant Illness and Device Imaging

Abstract

The past six decades of silicone breast implant history encompass manufacturing secrecy, regulatory laxity, inadequate informed consent, clever advertising, overly simplistic research methodology, diverse and controversial opinions, changing social patterns, safety issues, information ambiguity, speculation, and deception. This review addresses the verifiable clinical, radiological, and pathological aspects of these devices, particularly with regard to silicone bleeding. This information can favorably assist practitioners and radiologists facing diagnostic challenges encountered in patients with silicone breast implants.

Why Is the Baker Classification Inadequate for Classifying Silicone Implant Fibrous Capsules?

“…Until recently, silicone extravasation was believed to be rare in new generations of implants, and extravasated particles were inert to the human body [ 14 ]. This concept has already been changed, supported by the latest recommendations from the FDA, which recognizes gel bleeding and relates it to some clinical symptoms and diseases of the immune system [ 3 , 4 ].…”

Biofilm-derived oxylipin 10-HOME mediated immune response in women with breast implants

“…Laboratory testing that is sensitive or specific for BII remains to be identified (8). There are multiple competing theories as to the cause of BII, although to date none have been convincingly proven (9). Previous clinical studies have shown chronic infections are present in a high proportion of explants for BII, although these studies have been limited by the relatively low sensitivity of typical clinical microbiological testing in identifying organisms that are implicated in chronic infections (6).…”