Are breast implants safe for someone with an existing autoimmune disease?

Question

I'm a 49yo woman considering breast augmentation, but I'm concerned about the safety. I have a very mild condition of ankylosing spondylitis and I'm HLA b27 positive. I don't take any medications as my disease has stayed at a barely detectable level for years and pain and inflammation are mild to nonexistent most of the time.

Donovan Rosas, MD · Answer

Silicone implants are safe. Period
Breast Implant Illness  and silicone related medical complications are controversial topics. It is a phenomenon which is supported by a wealth of anecdotal data (patient testimony) but no empiric data  (hard scientific research). Patient reports a litany of symptoms which they attribute to their implants but the connection is difficult if not impossible to prove via laboratory study.
Physician scientists may recognize anecdotal data but unless it is supported by Class I empiric data, it is difficult to place a great deal of faith in it. Clinicians make decision based upon evidence based medicine. 
That being said, it is easier to identify what one knows rather than what one doesn't.
What we do know is that by all available measures today...implants are safe and specifically silicone implants are safe.
Silicone breast implants are among the safest medical devices in use today. These devices are also among the most rigorously studied and tested medical devices currently being used in the U.S. today. It is biologically inert  and in that respect no different than the titanium used for bony fixation. There has been no demonstrated link between silicone and the commonly cited myth of autoimmune disease.As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Gerald Minniti, MD, FACS · Answer

Hello,I must admit, I had a hard time following some of the answers to your question form other docs.  Let me be very clear: 40 years of every statistically significant study, both prospective and retrospective, some involving hundreds of thousands of woman, show no correlation between silicone gel implants and auto-immune disease. Best of luck!

Alexander Zuriarrain, MD, FACS · Answer

Hello and thank you for your question. 
To be completely honest, I do not know of any contraindication to breast augmentation in a patient with ankylosing spondylitis. There are autoimmune conditions which have been found to cause problems with wound healing and surgery in these patients is contraindicated. Examples of these autoimmune diseases include scleroderma and lupus. I have come across textbooks that state that cosmetic surgery should be avoided in patients with rheumatoid arthritis but I have never seen any data or research to include ankylosing spondylitis. Most patients with autoimmune disorders consume steroids or other immunosuppressive medications and these patients should definitely not have insertion of a breast prosthesis because they are at high risk for a complication. 
Nonetheless, every operation has its risks and a discussion with your immunologist prior to undergoing any operation involving placement of a prosthetic device should be discussed in significant detail. It would be wise to have a consultation with a fully trained plastic and reconstructive surgeon who can be in contact with your immunologist in regards to further answering your question.
All the best!
Alex Zuriarrain, MD, Plastic Surgery

Carlos Gonzalez Legarda, MD · Answer

The implant is a foreing body that is going to activate the inmunological system. Also the surgery is a major trauma that is going to activate your inmunological system and inflamatory response. So in my opinion, you shouldn't have the surgery.

Are breast implants safe for someone with an existing autoimmune disease?

Answers (4)

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