Migration and Accumulation of Silicone in the Liver of Women with Silicone Gel‐Filled Breast Implants

Abstract

1H NMR localized spectroscopy (STEAM), combined with echocardiography (ECG), respiratory gating, and water and fat suppression, was used to quantify silicone concentrations in the liver of women with silicone gel-filled breast implants. Localized spectroscopy was performed on 15 patients with silicone gel-filled breast prostheses and on eight volunteers with no implants. The 1H spectra in the liver of patients showed silicone resonances from 0.3 to -0.8 ppm, attributable to protons in the methyl groups of silicone. The presence of silicone in the liver could first be detected 3-4 years after breast prostheses implantation. No correlation between silicone concentrations and implantation times was observed. However, our results indicated that silicone concentrations may reflect implant integrity: detectable silicone concentrations in the liver appeared to be higher when the implants were ruptured than when the implants appeared intact. Moreover, new resonances in the range of -2.6 to -4 ppm were observed in most patients after long-term implantation. As these species increase with implantation time, the new resonances may reflect chemically changed silicone (paramagnetically shifted silicon complexes bound to iron) accumulated over time. The sensitivity of 1H NMR localized spectroscopy is sufficient to detect silicon concentrations as low as 0.20 mM. Results from one patient whose implants had been removed 14 months prior to the NMR examination showed no detectable silicone in the liver, indicating that it may have been excreted via bile or degraded to silica and high coordinated silicon complexes. Quantitative 1H localized spectroscopy of the liver in women with silicone gel-filled breast implants may provide valuable information concerning silicone accumulation and degradation in vivo, as well as about the kinetics of its elimination from the body after implant removal.

Bioavailability of Octamethylcyclotetrasiloxane (D 4 ) after Exposure to Silicones by Inhalation and Implantation

“…Using the data of Utell et al (11), we exposed subjects to 10 ppm D 4 by inhalation for 1 hr. This exposure period consisted of 10 min rest, 10 min exercise, 20 min rest, 10 min exercise, and finally 10 min rest before the D 4 inhalation was terminated.…”

“…Residual LMWS ranged from 0.2 to 2% by weight for the silicone gel and 0.01% to 0.1% for the silicone envelope (1.04-10.4 mg) (5)(6)(7)(8)(9). Numerous studies have documented the migration of significant amounts of LMWS out of breast implants into surrounding breast tissues and to the liver (8)(9)(10)(11). This would add to the dermal or inhalation exposures from personal care products in a typical woman.…”

“…At high doses, mice and rats had enlarged lungs and liver as well as developmental effects such as decreased live litter size, number of pups, and number of uterine implantation sites (1,4,12,13,15). There is little information concerning the effects of the highly lipid soluble D 4 in humans, but it is not expected to be inert if it accumulates in the body (9)(10)(11)(12).…”

Analysis of periprosthetic capsular tissue from women with silicone breast implants by magic-angle spinning NMR

“…The bleeding of PDMS through the implant envelope has been associated with the formation of thicker capsules and capsule contracture (7)(8)(9). Studies have also found that silicone can migrate from the site of implant or injection to distant regions such as the liver, joints, and lymph nodes (10)(11)(12)(13)(14). Although there is no established connection between exposure to silicone and connective tissue diseases (15)(16)(17)(18)(19), the hypothesis that silicone breast implants may be associated with autoimmune disorders has increased the interest in understanding and characterizing silicone and its interaction with tissues.…”

Silicone granulomas: 30 years after injection of fluid silicone for breast and inner thigh augmentation – a possible case of human adjuvant disease improved after massive siliconomas removal

“…The steroid could be stopped for as long as 15 days, the leg problems would then recur. Abdominal and thigh MRI scans were performed to detect further spread of silicone [5,18].…”