Why do breast implants make some women sick and not others?
Doctor Answers 4
Why do breast implants make some women sick?
The simple answer is that they don't. There was a suggestion in the 1990's that they might, resulting in a massive overreaction from the FDA (and even a huge payout in court) but subsequent investigation has shown absolutely no link between silicone implants and chronic disease. You can rest assured that, as long as the manufacturer adheres to the strict controls necessary for FDA approval, your implants would never 'make you sick'
Breast implants causing illness
In the 1990s media reports about silicone breast implants causing chronic systemic disease were overreacted to, resulting in public panic, the FDA removing them from the market, companies going bankrupt, and unnecessary surgeries being performed to remove them from patients bodies. These reports were later rigorously examined through comprehensive scientific studies and it was found that there was in fact no link between silicone breast implants and autoimmune disease. Following this, the implants were placed back on the market. A fascinating account of the unfounded claims that stoked these events can be found in the book Science on Trial by Marcia Angell. The bottom line is that numerous stories still circulate about how silicone breast implants make patients sick, but this has scientifically be shown over years of study that they do not cause systemic illness and that they are in fact safe.
In order to get a qualified, ethical, and expert opinion on your surgical options and expectations, always have an in-person consultation with a plastic surgeon certified by the American Board of Plastic Surgery.
Best of luck,
Keith M. Blechman, MD
New York, NY
Breast implant induced illness
It is a fallacy that implants cause auto-immune diseases. This was debunked years ago after extensive testing and clinical studies.
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Sickness from implants?
Thank you for your question!
I believe when you say sickness - you are referring to autoimmune diseases which appears in multiple blog articles on the net. These sources are not trustworthy or accurate. You will also notice that the majority of the articles on the net will site SILICONE implants as the culprit. Even if you agree with those articles, please don't transfer the blame to saline implants.
Please understand that there is NO link between autoimmune diseases and silicone implants according to current research.
You see, we are naturally scared of things we do not know or things we do not understand. It is okay to feel concerned especially because there still isn’t much information on the prevalence of autoimmune disease after breast augmentation surgery. You see, ASSOCIATIONS have been found in a very small subgroup of patients in multiple old studies, but there is still no conclusive evidence that proves that silicone breast implants CAUSE autoimmune diseases. Associations don't tell us anything special because you can find an association between anything such as things like eye color and your likelihood to come into a car accident, or the emotional state of mind and the color of shirt you are wearing. To make associations meaningful, 2 things are needed - 1) the association should be strong, and 2) there should be a logical and scientific explanation for the connection. Without this, associations are nothing!
As such, calculating your chances of implants making you sick cannot be done, because it is not proven that implant cause sickness. Several studies implicate that there is no increased risk to develop autoimmune diseases after silicone breast implant insertion which is why the FDA lifted the ban on these implants in 2006. So, educating ourselves in this field is important so that we do not take things out of context.
Also, please note that compared to the number of people who get BBAs each year (over 300,000), very few (less than 1%) actually experience autoimmune disease-related clinical symptoms. Based on current evidence from CLINICAL TRIALS, we can say that silicone breast implants are safe, especially with the new current generation implants.
Below, I describe 3 research papers from between 2015-2016 which suggest that silicone implants MAY be ASSOCIATED with autoimmune disease-related SYMPTOMS, but the studies are NOT long-term clinical trials. Please note that the studies only found a link between the silicone implants and autoimmune disease-related SYMPTOMS, but NOT with the autoimmune diseases itself.
1) In the 30 year comparative study by Colaris et al., 100 patients who had autoimmune/inflammatory syndrome induced by adjuvants (ASIA) due to silicone implants were diagnosed in 2014 in Netherlands and were compared with another set of 100 patients with the same diagnosis between the years 1985-1992 in USA. The study found that most patients at both periods of time (1985 and 2014) had clinical symptoms required to diagnose ASIA: chronic fatigue, arthralgia (joint pain), myalgia (muscle pain), cognitive impairment, pyrexia (fever), and sicca (dry eyes). They also found that 52% of patients in both groups had allergies. In the 2014 group, 34 patients were diagnosed with an autoimmune disease. They found that from the 54 patients who underwent removal of their silicone breast implant, 50 % (n = 27) of the patients experienced improvement of complaints after explantation of the implant. This also means that 50% did not, so we still can’t say that the implant is the problem. The authors found that the median time it took for patients to have clinical symptoms was 4 years. The median time between implant and diagnosis was 13 years. The authors of the study conclude that even though changes were made to silicone implants during the past 50 years, the presence of similar symptoms in the 2014 group links silicone implants to autoimmune diseases.
Colaris, M. J. L., Boer, M. de, Hulst, R. R. van der, & Tervaert, J. W. C. (2016). Two hundreds cases of ASIA syndrome following silicone implants: a comparative study of 30 years and a review of current literature. Immunologic Research, 1–9.
2) In a study by Boer et al., patients with implants who had nonspecific complaints such as joint pain, muscle pain, and fatigue had their implants explanted. This was done to see if explantation of silicone implants will reduce the clinical symptoms so that it can be advised as an effective therapy for these patients. The study found that explantation improved silicone-related complaints in approximately 75% of the patients (469 out of 622). Autoimmune diseases improved in 56% of patients (10 out of 18) only when removal of implants was coupled with immunosuppressive therapy.
Boer, M. de, Colaris, M., Hulst, R. R. W. J. van der, & Tervaert, J. W. C. (2016). Is explantation of silicone breast implants useful in patients with complaints? Immunologic Research, 1–12.
3) In a review by Goren et al., 4 groups of patients were suggested to be at risk or a predisposition of silicone-implant related autoimmune disease and these patients should not be considered for silicone implantation just to be safe. 1st group are those with prior documented autoimmune reaction to an adjuvant such as a vaccination, implant, etc. 2nd group are those with established autoimmune conditions such as Graves disease, type 1 diabetes, rheumatoid arthritis, etc. 3rd group are those with a history of allergic conditions such eczema, hay fever, pollen and dust allergy, drug allergy and rubber or latex allergy as 75% of patients whom experienced symptoms of autoimmunity to silicone had prior allergies. 4th group are those who are prone to develop autoimmunity due to genetic linkage or prevalence in the family. Several studies have acknowledged increased tendency for development of autoimmune diseases among relatives of patients with rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus, and more. In one case report 3 sisters developed fatigue, arthralgia, myalgia, and sleep disturbances after they underwent silicone implantation and there symptoms alleviated after being given saline-filled implants.
Goren, I., Segal, G., & Shoenfeld, Y. (2015). Autoimmune/inflammatory syndrome induced by adjuvant (ASIA) evolution after silicone implants. Who is at risk? Clinical Rheumatology, 34(10), 1661–1666.
All three papers are NOT enough to say that silicone breast implants CAUSE autoimmune diseases. All that the studies show is that certain symptoms which can have multiple causes (i.e, muscle pain, fatigue, joint pain, and dry eyes) seem to get reduced after explantation of the implants in 50% to 75% of these patients. As you can see, neither study specifically linked autoimmune disease with breast implants. This is why we should not take things out of context and negatively connote silicone implants as unsafe.
I advise you to share your concerns with a board-certified plastic surgeon, and hopefully they can clear any misunderstanding and misconception. If you are worried a lot about silicone implants, then opt for saline implants or IDEAL implants.
Hope this helps and clarifies the current research out there.
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.