Silicone breast implants and autoimmune rheumatic diseases: myth or reality

Abstract

SBIs are associated in a proportion of patients with complaints such as fatigue, cognitive impairment, arthralgias, myalgias, pyrexia, dry eyes and dry mouth. Silicones can migrate from the implant through the body and can induce a chronic inflammatory process. Explantation of SBI results in the majority of patients in an amelioration of the symptoms.

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) demonstrates distinct autoimmune and autoinflammatory disease associations according to the adjuvant subtype: Insights from an analysis of 500 cases

“…These compounds significantly elicit immune system activation and responses, leading to tissue alterations and injuries. Different studies have shown that silicone breast implants (SBIs) may be associated to fatigue, cognitive impairment, arthralgias, myalgias, pyrexia, dry eyes and dry mouth [28][29][30]. A robust proof of this is given by the fact that removing SBIs leads to amelioration of the symptoms [31].…”

Mechanisms of Breast Implant Toxicity: Will the Real Ringmaster Please Stand Up

“…Numerous publications in the past five years have supported the assertion that silicone gel-filled breast implants are genuinely capable of causing a novel systemic illness (1,2,3,4,5,6,7) . Prior claims of a similar nature existed in the 1990's when the controversy first swirled around this issue, but legitimacy at that time was elusive due to faulty methodologies utilized by many investigators (1,4) .…”

“…Heavy metals adversely affect enzymes, DNA, and leukocyte respiration; can be toxic to muscle, brain, lungs, kidneys, liver, blood, and nerves; and when present in excess amounts can mimic multiple sclerosis, Parkinson's, Alzheimer's, and muscular dystrophy (21) . Clinical correlates reported in implant recipients include (but are not limited to) hair loss, recurrent infections in a variety of sites, weakness, fatigue, muscle twitching, nail cracking and splitting, cognitive dysfunction, a multitude of other nervous system disorders (e.g., paresthesias; dysesthesias; dizziness; gait imbalance); and abdominal pain, nausea, constipation, and loose stools from dysfunction of the myenteric plexus) (1,2,3,4,5,6,7,12,16,20,22) . i.…”

“…In a recent publication, Tervaert and colleagues revisit their implant recipients' clinical manifestations and continue to invoke causation via autoimmune and inflammatory mechanisms (6) . This is a gross oversimplification of what is clearly a much more complicated process and is compounded by a subtle attempt to expand their diagnostic ASIA criteria to be more encompassing (changes that the reader could easily overlook if one did not compare this publication to prior ASIA guidelines) (9) .…”

“…Silicone-induced autoimmune theories have recently been resurrected in the form of ASIA (autoinflammatory syndrome induced by adjuvants, or Shoenfeld's syndrome), which promotes the concept of multi-organ inflammatory responses to silicone gel (3,5,6,7,9) . The deficiencies of ASIA and the failure of its proponents to consider multiple other mechanisms of disease causation have been outlined in a recent letter to the editor (10) .…”