Chronic Pulmonary Silicone Embolism from Breast Augmentation Is Not a Common Finding in Explanted Lungs

Abstract

Objective Acute pulmonary silicone embolism (APSE) related to subcutaneous silicone injections is a well-known entity. Recently, a few cases of pathologically confirmed chronic pulmonary silicone embolism (CPSE) from breast implants have been reported. The prevalence of CPSE in women with breast augmentation is unknown. This study was done to determine the prevalence of CPSE in female lung transplant recipients with a history of breast augmentation and to determine whether breast augmentation plays a role in chronic lung diseases requiring lung transplantation. Methods A retrospective chart review was performed to identify female lung transplant recipients with a history of breast augmentation prior to or at the time of lung transplantation. Ten patients meeting these criteria were identified. The pathologic features of the explanted lungs of these patients were reexamined for CPSE by a board-certified pathologist with expertise in lung transplantation and pulmonary embolism. Results Of 1518 lung transplant recipients at Cleveland Clinic, 578 were females. Of 578 females, 10 (1.73%) had history of breast augmentation. A total of 84 H&E-stained slides from the explanted lungs from 10 cases were examined. No pathologic evidence of chronic silicone embolism was seen in any of the 10 cases. Conclusions CPSE is not associated with pulmonary disease leading to lung transplantation. Breast augmentation is not a significant contributor to pulmonary disease requiring lung transplantation. Further studies are required to ascertain the prevalence of CPSE in the general breast augmentation populace and to define the relationship between breast augmentation and pulmonary disease.

Pulmonary fibrosis and embolism secondary to silicon implant leak

“…These symptoms were described in 2011 by Schoenfeld et al as autoimmune/inflammatory syndrome induced by adjuvants 8 9. In recent literature, there have been six cases described to have chronic silicone embolism,4 our case presentation is seventh among chronic silicone embolism, supporting previous studies contradicting safety of silicone breast implants.…”

“…Findings suggested in our patient are found in literature as most common outcomes of ruptured breast implants and silicone emboli. Events include hypoxia, embolisms, pneumonitis, alveolar haemorrhage, congestion and ARDS 4 10. Our patient’s breast implants were removed; a practice has been done in previous studies with a hope to remove trigger stimuli to avoid future complications but therapeutic significance and improvement of symptoms following removal of breast implants has not been reported in literature 5 9.…”

“…Breast implants were first introduced by Czerny by using a lipoma 4. Safety of silicone implants became a concern after first case of silicone pneumonitis was reported in 1976 5.…”

Fabrication and Analysis of Polydimethylsiloxane (PDMS) Microchannels for Biomedical Application

“…It has not been reported in literature that PDMS implantations has caused any infection in connective tissues that leads PDMS is very safe to use for implants [6,13,15,58,59]. PDMS has been used for facial implantations, stomach wall infection treatment, retinal implants, tendons and ligaments surgeries, breast implantations and expansion, spine surgery, cardiac and vascular muscles, knee treatment and replacement and rat implantations [60][61][62][63][64][65][66][67][68][69][70]. Some PDMS implant investigations are listed in Table 2.…”

Interleukin-17 and senescence regulate the foreign body response

“…While fibrosis may be leveraged to stabilize some implants such as orthopedic implants or stents, it can also lead to implant contraction in the case of hernia meshes and breast implants. Silicone breast implants are widely used in medical practice but develop fibrotic capsules that can necessitate replacement [2]. Further, some recipients experience breast implant syndrome that includes increased risk of rheumatologic disorders [3].…”