ANA 1:320 (Speckled) before Breast Augmentation: Is the risk of a "Trigger" too high?

Question

I am a 25F scheduled for silicone breast augmentation this Friday. While doing pre-op labs , I proactively checked additional markers to establish a "baseline" in case of future BII concerns. To my surprise, I found an ANA titer of 1:320 (Speckled). Aside from long-standing baseline fatigue (not a new symptom), I am healthy. Initial labs were reassuring: CRP (Normal), TSH/TPO (Normal), CBC (Normal, MCV 99), and PT/PTT (Normal). I am currently waiting on a comprehensive follow-up panel (Sm/RNP, SSA/SSB, Scl-70, dsDNA, C3/C4, ESR, and Complete Urinalysis) to rule out active disease. I am wary of risking my long-term health for aesthetics. Many BII accounts come from women who lacked baseline screening; I am unsure if their issues were caused by the implant itself, or if the implant acted as an adjuvant that triggered a pre-existing condition they weren't aware of. If follow-up markers are negative, does this confirm the ANA is "silent," or is 1:320 still a significant risk for an immune trigger? To minimize "foreign body load," would a lower CC volume significantly reduce the risk of a systemic response, or is the material the trigger regardless of size? If I were your daughter or sister, knowing I had a 1:320 ANA but negative specific markers, would you honestly suggest I proceed with silicone, or skip it to avoid a potential systemic autoimmune response? THANK YOU in advance surgery is coming up in a few days so I’m panicking :(

Shlomo Widder, MD · Answer

Dear Sarah,
    Sorry for your stress just before getting a beautiful surgery. Positive ANA test does not mean that you have auto immune disease , or that you will develop  BII. Positive ANA can be a lab error or false positive and you might benefit from repeating the test. Also, positive ANA can result from viral infection, so you need to rule it out. Since you are concerned about your lab result, consult with a Rheumatologist and get cleared for surgery. 
   Let me tell you about my own experience, I have been in practice for over 38 years and performed breasts augmentation with implants on over 3000 patients. Through the years only about 3-5 of my patients asked to remove their implants because of BII concerns. After the removal of the implants I followed up the patients for few month and in no case did the symptoms improved, which for me meant that the symptoms were unrelated to the implants. I use almost exclusively saline implants made by Mentor, so you might consider using these implants as oppose to the silicone implants.
    Always consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage, nice upper pole slope, perky, symmetrical and natural looking.
                 Good luck,
                                     Dr Widder,
                             widderplasticsurgery.com

ANA 1:320 (Speckled) before Breast Augmentation: Is the risk of a "Trigger" too high?

Answers (1)

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