Medicine / Plastic Surgery
ATTN: Medical Professionals - Want to get published and be heard on nyjsm.com?
Click Here to Submit your Educational Article or Professional Medical Opinion

Advertisement:

Kaplan Test Prep and Admissions (Kaptest.com)


Breast Implants, A "Foreign Body".

April 14, 2007

Matthew Vasey, MD



Friday, November 17th, 2006 marked a historic day in the War on the American female breast. The FDA decided that it is now okay for doctors to put in silicone gel-filled breast implants after nearly a 15 year ban following concerns about safety and efficacy. Safety of the devices remains a controversial topic. It is accepted that the silicone does not cause cancer, nor does it cause a specific disease of the musculo-skeletal system. That doesn't mean there are not complications to the surgery itself, a risk of potential rupture, as the FDA now clearly states these are NOT lifetime "devices" and most women will require at least one additional procedure. The controversy comes from a collection of undefined vague and inconsistent autoimmune-type body complaints that may result from silicone breast implant shortly, or long after the surgery.

A large study of nearly 4000 women in Sweden compared those who received silicone implants to those who underwent breast reduction surgery in attempt to see how their complaints many years after their surgery matched up. (2)

The following complaints/symptoms were asked of these two groups:
(*Symptoms registered significantly more by post-implant patients as compared to post-reduction patients are starred)
Painful joint(s) for more than 3 months*
Swelling of joint(s) for more than 1 week
Muscle pain for more than 3 months*
Persistent or recurrent muscle weakness*
Regularly burning eyes
Persistent or recurring dry eyes
Recurrent sensation of sand or gravel in eyes*
Dry mouth for more than 3 months*
Ulcers in the mouth for more than 3 weeks
Difficulties with swallowing*
Unexplained fever*
Night sweats
Skin redness on both cheeks*
Skin abnormalities (not moles) worsen in sun
Other skin abnormalities*
Hypersensitivity to sunlight
Attacks of impaired circulation in toes or fingers
Tingling and numbness*
Persistent or recurrent headache
Persistent or recurrent neck ache*
Persistent or recurrent shoulder ache*
Persistent or recurrent backache*
Abnormal fatigue*
Depression/Low-spiritedness*
Memory difficulties
Hard to find words*
Hair loss*
Persistent constipation

While in this study, there are a number a complaints registered more frequently in post-implant patients, the complaints lacked consistency with recognized diseases of the musculo-skeletal system and indistinctive to warrant creation of a new "Post-Silicone Breast Implant Disease". These findings could only conclude these symptoms are more common in women after cosmetic breast implant surgery than women who have had breast reduction surgery. (2) Another large study of the Dutch used a similar technique to conclude increased reporting of musculo-skeletal symptoms after a cosmetic breast surgery as well (3). While the medical literature continues to come up short associating silicone implants to disease (2) many doctors still believe, passionately, implants put women at higher risk of unexplained systemic complaints compared to those who remain implantless. (4)

Few things are black and white on this issue. A breast implant is a "foreign body". The immune system of your body attacks "foreign bodies" and thankfully, for our protection, it does a pretty good job of this. It only knows how to fight what is not normal. Perhaps most importantly, just as what creates variations in female breast size creates variations in one's immune system response.


References:

1. Bondurant, S., Ernster, V., Herdman, R. Safety of Silicone Breast Implants. Washington D.D. National Academy Press, 1999.
2. Fryzek, J., Signorello,L., Hakelius, L. Self-reported symptoms among women after cosmetic breast implant and breast reduction surgery. Plastic and Reconstructive Surgery. 107(1)206-213. 2001.
3. Giltay, E., Bernelot Moens, H., Riley, A. Silicone breast prostheses and rheumatic symptoms: A retrospective follow up study. Ann. Rheum. Dis. 53:194. 1994.
4. Solomon, G. A clinical and laboratory profile of symptomatic women with silicone breast implants. Semin. Arthritis Rheum 24:29, 1994.
NYJSM.com on Social Media