Concerns about autoimmune disorder and silicone in cohesive gel implants. Mother has scleroderma a few years later.

I wanted to get implants but after my mother got diagnosed with scleroderma and my stepmother with lupus and they both blamed them on their implants. It made sense because the implants are so close to lymph nodes. Also the immune system may fight the implants as a foreign object, and in long term it may get out control and go against your own body. I am aware that there are no link between autoimmune diseases and silicone in studies but I'm not convinced.

Doctor Answers 7

Association of Silicone Breast Implants and Autoimmune Disease

Since you know that the studies done on silicone implants show no correlation of the implants with autoimmune disease, There is probably nothing I can say that will change your mind. However, the data actually shows that a lower percentage of patients with breast implants have autoimmune disease than the general population. With your family history, it is possible that you will develop some form of autoimmune disease whether you have implants or not. Therefore, if you desire breast augmentation, I would proceed with the procedure and do nothing later if you do develop a problem.


Highlands Plastic Surgeon
5.0 out of 5 stars 5 reviews

There is no known association between automimmune disorders and silicone breast implants

When implants are placed, the body forms a capsule around it because, as you correctly stated the body views it as foreign. However, there has been no direct relationship between silicone breast implants and autoimmune disorders. Between 1996 and 2006 there was a ban on the use of gel implants. They are now widely used because the 10 year accumulated data shows no link between silicone implants as such disorders. It is normal to be concerned about things you are not sure of. My suggestion is for you to sift scientific fact from anecdotal concern in order to make an educated decision. At the end of the day you have to be confident with your decision however. If you are still hesitant or concerned despite this, I suggest not having the procedure because you may run the risk of not being happy despite having an excellent aesthetic result.

Best wishes,

Dr. Ravi Somayazula

Ravi Somayazula, DO
Sugar Land Plastic Surgeon
4.8 out of 5 stars 53 reviews

No link between autoimmune disease and implants

Thank you for your question.  Unfortunately, there is lingering misinformation from bad reporting in the early 1990's linking silicone gel implants to autoimmune disease.  You are correct in that the body treats implants as foreign objects, and that is why the body walls off the implants inside the scar capsule (sac around the implant).  The body also forms a capsule around any other foreign device- joint implant, pacemaker, etc.   Silicone is derived from silicon which is in the same family as carbon and therefore is very similar and compatible with the carbon in the body.   Silicone is also used widely in medical devices, tubes, catheters, etc.  There have been numbers very large studies of women showing no risk of autoimmune diseases in patients with silicone implants.  In fact, there was a study the mid 1990's (around '95) of around 40,000 women that actually showed a lower risk of autoimmune disease in patients with silicone implants.  Unfortunately, autoimmune disease affects women at a much higher rate than men (lupus is 9:1 women to men).   And because women are getting the breast implants, there is an applied causation, which has been scientifically disproven in multiple, multiple large, long term studies.  Good luck.  

There is NO link between autoimmune diseases and silicone implants

Thank you for your question.

You see, we are naturally scared of things we do not know or things we do not understand. It is okay to feel concerned. There is still NO conclusive evidence that proves that silicone breast implants CAUSE autoimmune diseases. There is NO link between autoimmune diseases and silicone implants.

 

In fact, 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. Please note that you are correct that the immune system fights a foreign object, but in the context of implants, the body forms a fibrous capsule around it thereby completely limiting the interaction of the implant with the body. With the new cohesive gel implants, even if the implant ruptures, the gel remains restricted within the capsule.

 

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 linked 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 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 start thinking that silicone implants are not safe.

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.

Hope this helps.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 427 reviews

Concerns about autoimmune disorder and silicone in cohesive gel implants. Mother has scleroderma a few years later

This has been studied at length by the FDA. Silicone implants were even temporarily taken off the market while the potential was investigated. The implants were later placed back on the market because there was no risk found. There is no known link between silicone implants and autoimmune disease. While there are women with breast implants who do get autoimmune diseases, the rate at which this happens seems to be the same as in women without breast implants. In order to prove the issue indefinitely, there would need to be a much larger and longer study than any undertaken thus far. So far, all we know is that no study on the topic has proven a link, so that's the best evidence we have.

If autoimmune diseases run in your family, it may be worth getting a genetic screening yourself to find out your potential risks. Regarding the possibility of breast implants increasing those risks, there is no science to support that and breast implants have been proven safe by decades of testing on tens of thousands of women.  

Autoimmune disorders and gel implants

In the 1990s, huge international studies were done showing no link at all between gel implants and autoimmune disease. People do unfortunately get scleroderma and lupus and the frequency in the general population was the same as in those with implants.  There is always more to learn but given the state of medical knowledge today, there appears to be no connection with silicone gel.

That said, biofilms can form on any implant, including a breast implant. It is possible that in the future a link between biofilms and autoimmune disease will be discovered.

Breasts implants and auto immune disease

Dear Alexa,

   As the expression goes - "you can bring the horse to the water but you can't make the horse drink the water" . Well, there are many studies that dispel the notion of any connection between silicone implants or saline implants and auto immune disease. 

   I have been in practice for over 29 years and performed breasts augmentation surgery with (almost exclusively)  saline implants made by Mentor on thousands of patients. I never witnessed any connection between breasts augmentation with implants to auto immune diseases. So that is the best that I can do for your you in that regard. You cam also discussed your family history , as far as the auto immune disease that they have, with their rheumatologist  and get his or her's opinion concerning breasts augmentation.

   Breasts augmentation with implants is one of the best investment that you can make in yourself. It will increase your confidence, your self esteem, your sense of femininity and will make shopping fun...

   You have to realize, though, that not all results are the same, because experience, skills and aesthetic eye are critical for good outcome. So, do your due diligence and choose your surgeon wisely, in order to avoid bad result and need for corrective surgery.

   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, perky, symmetrical and natural looking.

                             Best of luck,

                                                  Dr Widder

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.