How Common is a Silicone Allergy with Silicone Breast Implants?

Question

Is there any way to test for a silicone allergy? Is it rare or common to be allergic to the silicone implant shell?

Gregory Turowski, MD, PhD, FACS · Answer

It is possible to develop an allergic reaction to almost any product or substance in our surroundings. . However the silicone allergies are very rare and uncommon .Silicone is found in many household items such as hand lotions, polishes, waterproof coatings and even processed foods. Therefore allergy to silicone can one develop even without the existence of silicone breast implants.

Richard J. Bruneteau, MD · Answer

There has
never been an implantable device studied as extensively as silicone breast
implants.In 1990, silicone implants
were taken off the market by the FDA.Since that time, multiple studies have been performed that have
evaluated the safety of liquid silicone and the Silastic implant shell.None of these studies have demonstrated
silicone allergies.It’s also important
to realize that silicone is present everywhere in our environment.It’s even present on needles that are used
for medical injections.Although
silicone implant allergies are probably extremely rare, in someone with your
history of allergies, it’s probably reasonable to consult an allergist before
proceeding with breast augmentation surgery.

Larry S. Nichter, MD, MS, FACS · Answer

Silicone allergy would rare if at all possible. The FDA has studied Breast implants for more than thirty years and it has not identified allergy to silicone as being a concern. By the way silicone is on coatings of some needles, IV catheters are made of silicone as are many other implants in the body, and many antacid/antigas medications taken orally have a silicone derivative as one of its components.

Raffy Karamanoukian, MD, FACS · Answer

Although most of us believe that silicone is an inert substance that is hydrophobic in molecular structure and safe to use, I would not advise you to undergo the procedure as there are isolated cases of inflammatory reactions arising from silicone or any type of foreign substance. In your particular case, it seems as though you have a quality of life issue with your allergies and we would not do anything to exacerbate it. I maintain a very conservative approach to elective surgery in patients with chronic health conditions.

John Philip Connors III, MD · Answer

This is a very intriguing question, and as far as I know there are no blood tests nor skin challenge tests for Silicone Allergies. A tremendous amount of scientific energy and resources have been put into researching the interactions of silicone with the human body, especially with respect to breast implants and there silicone polymer shells. We continue to research implantable prostheses such as this and use our data to take the best care of our patients possible...thus the very important reason why you should seek out a Board Certified Surgeon who is a member in good standing with the specific plastic surgery societies that promote, contribute to and report research.

Vincent N. Zubowicz, MD · Answer

I have never read of an antibody to silicone in humans. An antibody is a requirement for a true allergic reaction. The body does recognize silicone as a foreign object which is why capsules form around breast implants. Silicone does not have an organic moiety (an antigen) that triggers the body to produce an antibody. Silicone is useful because the foreign body response is very tame.

Steven H. Williams, MD · Answer

I agree with the physicians below.  Silicone is inert and should not be the cause of a true allergy.  In addition - almost all needles that are used to perform injections or place intravenous lines are coated with silicone to increase the ease of passing through the skin.
If you've had an injection or an IV you may have already had your allergy test.  I would like to add that both silicone and saline implants have silicone shells.  The exposure to silicone in your body for an unruptured implant would be the same.
Find a board certified plastic surgeon and discuss your concerns.  I hope this helps.

Armando Soto, MD, FACS · Answer

I agree with my colleague-
Silicone is an inert substance, and testing is not performed or necessary.  What you may be referring to is the formation of a tight scar capsule around the implants, known as capsular contracture.
The formation of a layer of scar tissue around your implants is normal, and is just the body's way of "walling off" the implant, which the body recognizes is not part of itself. This scar tissue "capsule" formation is normal, and happens any time a device is placed in the body (it happens with artificial joints and pacemakers too- which, by the way, have silicone in them as well).
What is sometimes a problem, is when the scar tissue capsule shrinks over time, leading to distortion of the implants, a poor contour, and sometimes discomfort.   While we do not know exactly what causes this to occur in some patients, it is possible to say that we believe some things may cause it or worsen it, such as infection or blood around the implant.
Over the past 20 years, and around the world, silicone filled implants have been proven to be safe- but you need to be comfortable. Talk to your board certified plastic surgeon about your options- but don't worry that you may be allergic.

Richard Baxter, MD · Answer

Silicone is one of the most biocompatible materials, which is why it is the chioce for many types of implants such as pacemakers and artificial joints. Various tests have been promoted in the past but results of these have not been confirmed to provide any useful information.
Allergy is one type of a family of conditions known as autoimmune diseases, and silicone was suspected as being a trigger for that; however, numerous large-scale studies have conclusively shown no association of silicone to autoimmune disease (or anyother disease for that matter).

David Bogue, MD · Answer

To answer your question regarding allergies and silicone implants, you need a little background regarding silicone. Silicone comes in different forms based on its molecular structure. This ranges from a low viscosity liquid form to a stable solid form. A common misconception is that silicone is inert. This is partially true. Solid silicone such as silicone rubber, the silicone elastomer shell of a breast implant, and silicone facial implants are inert. However, liquid silicone is intensely imitative. Injection of liquid silicone can cause very aggressive inflammatory reactions (which is why injecting liquid silicone is not approved for cosmetic purposes).

	The silicone polymers in today's implants resemble the elastomer shells much more than they resemble the oily liquid silicone commonly used as a lubricant. Because of the closer relationship to the solid form, cohesive gel silicone causes a very low grade inflammatory reaction. 

	A true silicone allergy is very rare. Silicone appears in everything from soaps, nail polish, chewing gum, processed food, and hand lotion. Typically, the allergy that is thought to be from silicone is actually from an additive used with the silicone, such as Latex. However, if you are concerned, you can have a skin test from a Board Certified Allergist to specifically check for a silicone allergy.