I Am Getting Breast Augmentation Surgery and Already Have Two Auto -immune Disorders

I was just recently diagnosed with Rheumatoid Arthritis and about two years ago was diagnosed with Hyperthyroidism. I understand that the science does not agree that auto-immune disease is related to breast augmentation with silicone, but can someone be honest and say whether or not the two diagnosis' that I have already will not possibly exacerbate a silicone implant toxicity? I choose silicone cohesive gel because I am only 5 ft, and 90 lbs.

Doctor Answers 9

Breast Augmentation and Auto-Immune Disorders

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To date there has been no concrete evidence of a link between auto immune problems and silicone implants.
Despite three decades of safety testing and monitoring of silicone breast implants, there is still a public perception that silicone breast implants are more toxic or dangerous than saline implants. The truth is that there has no known toxicity from silicone gel breast implants. In fact, silicone is one of the most common materials used in medical devices and implants. There is no known toxicity from silicone gel breast implants. It has been studied by the FDA for more than three decades to establish its safety. Silicone is the most common material used in medical devices/implants. Examples include shunts that go from the brain to the abdomen (for hydrocephalus) which are left in for a lifetime, artificial finger joints, syringes, IVs, catheters (including ones that go next to the heart), surrounding pacemakers, and even oral anti-gas tablets.
The one possible exception may by the PIP implant made in France (generally not available in the USA). Most of the concerns about the PIP implant were about the use of non-medical silicone and manufacturing problems, and do not relate to implants used in the United States by board-certified plastic surgeons. This is not to say that breast implants, like any implant, can have problems; they may have to be removed and are not meant to last a life time. Common reasons for replacement include: capsular contracture, rupture, infection, change in breast size, and pain—but not for toxicity.
To answer the perceived toxicity of Silicone by the general public—this is quite a different matter.
Breast implants have been around since the 1960s. About 15 years ago Connie Chung ran an exposé, Face to Face with Connie Chung, claiming silicone implants were responsible for different health problems. This led to lawsuits, a huge windfall for lawyers, and the subsequent ban on silicone implants for first-time breast augmentation patients went into effect. They were always available for breast reconstruction (e.g. after mastectomy) and replacement of existing silicone breasts. Also, please note that saline implants are still covered by a silicone envelope.
Soon after, a ban on silicone implant use became worldwide. This lasted for years until more than 100 clinical studies showed that breast implants aren’t related to cancer, lupus, scleroderma, other connective tissue diseases, or the host of other problems they were accused of causing.
June 1999, The Institute of Medicine released a 400-page report prepared by an independent committee of 13 scientists. They concluded that although silicone breast implants may be responsible for localized problems such as hardening or scarring of breast tissue, implants do not cause any major diseases such as depression, chronic fatigue syndrome, lupus or rheumatoid arthritis, etc.
The Institute of Medicine is part of the National Academy of Sciences, the nation’s most prestigious scientific organization.
Eventually, a federal judge dismissed/rejected the lawsuits, declaring them junk science and ended for the most part the barrage of lawsuits. This led to the present reintroduction of silicone implants years ago and their approval by the FDA. Interestingly enough, most of the rest of the world reintroduced them many years prior to the United States.

Medical clearance for plastic surgery

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Silicone implant toxicity is a non-existent entity. You already have auto-immune related diseases without breast implants. The question should be can silicone breast implants make these diseases worse than they otherwise would be. That is also highly unlikely. However, you need to take special precautions in order to have safe surgery and a smooth recovery. Your thyroid condition needs to be under control otherwise you are at risk for heart problems related to anesthesia as well as healing issues. I am unaware of any increased risk infection with rheumatoid arthritis but certainly if you get an infection around a breast implant it can aggravate your arthritis.

Given your medical conditions you should get medical clearance from physicians who take care of these conditions prior to any cosmetic surgery. Not telling your plastic surgeon about the conditions or not telling the other physicians about your cosmetic surgery puts you at unnecessary risk for any surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Breast Augmentation

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I am not aware of anyone who has silicone implant toxicity.  However, there are those who have implants which have ruptured and migrated, creating problems in the migration zones.  Your concern should be discussed with your Board Certified Plastic Surgeon and your endocrinologist and a plan developed for you.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Breast implants are not related to autoimmune disease.

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I don't see any problem with a patient suffering from a collagen-vascular disease (such as arthritis) having breast implants.  I think it would be a good idea, however, to have the blessing of the rheumatologist. There is no scientific evidence linking implants to autoimmune disease or making it worse.

I Am Getting Breast Augmentation Surgery and Already Have Two Auto -immune Disorders

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Best to have a "team meeting" between all your doctors to get a full understanding and medical clearances before proceeding with any cosmetic surgery, especially silicone implantation. 

Implants and auto-immune disease

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I think the science has been very thorough to show that there is no association between auto-immune disease and implants.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

No connection between autoimmune disease and silicone

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Since science is based on provable facts and not beliefs, we can say with a high degree of confidence that there is no copnnection between medical grade silicone and autoimmune diseases. In my clinical experience of several thousand augmentation patients over 20 years, I can honestly say that I can't think of a single case where there was a valid question about implants and autoimmune diseases. You should feel comfortable with your decision.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

No known autoimmune risk with silicone implants

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Several large studies--performed by both plastic surgeons and rheumatologists--fail to show any connection of autoimmune diseases to silicone implants.  "Silicone toxicity" is largely a myth. Hairspray has silicone; neurosurgical shunts are silicone; injection needles are coated with silicone.  Finger prostheses for joint replacement in patients with rheumatoid arthritis are made of silicone--and the patients do not get sicker after their joints have been replaced.

That does not mean that breast augmentation has no risks, but it will not be compounded by your arthritis or hyperthyroidism.

Once your medical problems are controlled and your physician clears you, you can go ahead.  You may also wish to consider saline implants which, though having a silicone shell, have no silicone gel.  Saline implants may give you peace of mind.

Mark B. Constantian, MD, FACS
Nashua Plastic Surgeon

Breast augmentation and autoimmune disorders

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Dear Carrinohio,


I am sorry to hear about your recent diagnosis.  As of today our literature of 20+ years shows correlations between the use of silicone gel implants and autoimmune diseases.  There have been some anecdotal correlations between the use of breast implants and anaplastic Large cell lymphoma, a rare type of non-Hodgkin’s lymphoma.  These recent correlations are being investigated.  I would first treat your other medical conditions first.  Obtain a good general healthy life and then consider having cosmetic procedures. 

Ernesto Hayn, MD
West Palm Beach Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.