Silicon Analysis of Breast and Capsular Tissue from Patients with Saline or Silicone Gel Breast Implants: II. Correlation with Connective-Tissue Disease

Abstract

The silicone breast implant controversy rages on. Recent work has demonstrated that normal or baseline breast tissue silicon levels in women who had had no prior exposure to any type of breast implant may be as high as 446 microg/gm of tissue. These data ranged from 4 to 446 microg/gm of tissue, with a median of 27.0 microg/gm of tissue. In addition, numerous other epidemiologic and rheumatologic studies have demonstrated no association between silicone breast implants and any connective-tissue diseases. Despite these reports, the use of silicone implants remains restricted. The present study measured breast and capsular tissue silicon levels from 23 breasts in 14 patients with saline implants, and from 42 breasts in 29 patients with silicone implants. No patient in the saline implant group presented with signs or symptoms of connective-tissue disease. Patients with silicone implants, however, were divided into three groups based on the presence or absence of signs or symptoms of connective-tissue disease: group I, no symptoms or signs; group II, + symptoms, no signs; and group III, + symptoms, + signs. Six patients in group III were diagnosed with a specific connective-tissue disease, including systemic lupus erythematosus, rheumatoid arthritis, or scleroderma. The most common indications for implant removal or exchange were capsular contracture and implant rupture, although 41 percent of patients with silicone implants expressed media-related concern over the implant issue. The most common symptoms described by patients in groups II and III were joint pain and stiffness, arm pain and numbness, and fatigue. In all groups, capsular tissue silicon levels were significantly greater than breast tissue levels. This finding may indicate that the capsule serves as a barrier to the distribution of silicone from the implant into adjacent breast tissue. Although breast tissue silicon levels in patients with silicone implants were not significantly greater than those in patients with saline implants (p = 0.48), capsular tissue levels in patients with silicone implants were, indeed, significantly greater than those in patients with saline implants (p < 0.001). However, no statistically significant differences in tissue silicon levels were observed with relation to the presence or absence of connective-tissue disease signs or symptoms in patients with silicone implants (groups I to III). Therefore, these data strengthen the conclusion that there is no association between tissue silicon levels and connective-tissue disease.

Análise das trocas de implantes mamários nos últimos cinco anos na Clínica Ivo Pitanguy

“…No passado, cogitou-se a possibilidade dos implantes de mama estarem relacionados a doenças reumatológicas, fato que não foi corroborado por nenhuma publicação posterior [12][13][14] , sendo que apenas uma publicação demonstrou associação entre a presença de silicone extracapsular e a ocorrência de fibromialgia 15 . No presente estudo, observamos que a maioria absoluta dos procedimentos de troca dos implantes de mama (73,5% dos casos), ocorreu por motivo estético.…”

Compromised Production of Extracellular Matrix in Mice Lacking Secreted Protein, Acidic and Rich in Cysteine (SPARC) Leads to a Reduced Foreign Body Reaction to Implanted Biomaterials

“…[17][18][19] Its lack of porosity does not allow ingrowth of cells, ECM, or blood vessels. In contrast to PDMS, cellulose Millipore filters are porous.…”

Use of the breast implant for liver graft malposition

“…Thus, saline implants, as used in our case, are generally preferred. 10 To date, more than 1 year postoperatively, there have been no complications in our case, either infectious or otherwise.…”