Should I cancel my BA procedure since I have RA? Or switch to saline?

Question

At the last minute my rheumatologist told me that if I can avoid having BA I should since I have RA and she said that I would possibly be at a higher risk of developing other conditions like sclerdoma or lupus as a result of the silicone implants. She said if I did decide to go through with it she would recommend saline vs silicone. At this point I’ve already paid for the procedure so it would be costly to back out and I have concerns with saline since I hear it looks more fake. Thoughts?

Aldo Guerra, MD · Answer

The information your rheumatologist has been given has no scientific basis in the medical literature. While not definitive of increased risks, the use of breast implants in the face of autoimmune disease is controversial.Read the FDA disclosure brochure on this topic. I suggest you speak with your plastic surgeon as well.Good luck. Dr. ALDO

Kevin G. Rose, MD · Answer

Thanks for the question. RA is so troublesome for patients! However, the good news is that most recently, RA has been linked to leaky gut syndrome, NOT silicone breast implants. Look up Dr. Steven Gundry. He wrote a book which is on the NY Times best seller list called “The Plant Paradox”. I highly recommend it! It will change your life! Silicone is an inert substance and as such can not contribute to disease. Saline implants have a silicone shell as well, so either way you would be getting silicone implanted. If you are dead set against implanted silicone then the best thing to do is to use your own fat and do an autologous fat transfer assuming you have enough fat stores to do so. The limitation being the total fat that can be transferred at one time. Most patients would benefit from two stages if they don’t have access to the BRAVA device which expands the space for fat transfer. Good luck!

Graeme J. Southwick, MBBS, FRACS · Answer

Thank you for your question. As far as saline implants being a better choice for RA patients than silicone, there is no medical reasoning behind that assertion. Advances in silicone implants have made them more durable and the chance of leakage is very low. That being said, this is something you should discuss with your specialist plastic surgeon prior to your surgery. They can answer your questions and put to rest any concerns you may have about the implants. Good luck!

E. Ronald Finger, MD · Answer

Personally, I have never seen any studies that link silicone implants to RA or any other autoimmune disease. Plus, I have performed breast implants on numerous patients with RA through the years and have seen no deleterious effect from them. The new Memory gel implants are much better than the old silicone implants and don't "leak" out. The saline implants are not bad if you have enough breast tissue that any wrinkles don't show. You should ask your PS about this and get his/her opinion on this, however.Thank you for your interesting question, and good luck.

John Rosdeutscher, MD · Answer

Good, solid scientific research has shown that rheumatoid diseases are no more prevalent in women with breast implants than the general population of similar-age women (breast implants do not cause rheumatoid disease). The issue may be that if you already have RA & are being treated with biologics that may cause some immunocompromise, a breast implant is a foreign body. Theoretically the implant could be slightly more prone to getting infected or other healing problem. On the other hand, theoretically your RA treatment may make you less likely to develop capsular contracture or other foreign-body reaction. In the real world I believe the theoretical arguments are probably nothing more than that & you have very little if any increased risk of problems. Hope this helps & best of luck!

Connie Hiers, MD, FACS · Answer

There is no medical evidence that silicone implants cause lupus or scleroderma. However, there is more foreign material with silicone implants than with saline. The current gel implants do not leak like the old gel implants, and have much lower risk of hard capsule formation. I do recommend not choosing large heavy implants that may give shoulder and neck discomfort over time. Do discuss all your concerns with your surgeon.

Should I cancel my BA procedure since I have RA? Or switch to saline?

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