Silicones breast implants

Garrido, L. and Young, V.L. Analysis of periprosthetic capsular tissue from women with silicone breast implants by magic-angle spinning NMR, Magn. Res. Med., 42, 436, 1999. 

Siggelkow, W. et al. In vitro analysis of modified surfaces of silicone breast implants. Inti. J. Artif. Org., 27, 1100, 2004. 

On the other hand, silicone s reputation nosedived when Dow Coming, the major manufacturer, was forced to hand out billions of dollars of compensation in response to lawsuits claiming that leakage of silicone breast implants had damaged the health of many women. These implants contain silicone oil within a sac of rabbeiy silicone. The charge was that silicone had led to autoimmune diseases in implantees. There is still no clear evidence that the compound is harmful in any way, but nevertheless in 1992 a moratorium was imposed in the USA on its use for implants. 

This subject was studied in relation to the silicone breast implant controversy of the 1990s. Silicone-fiUed artificial breasts were coated with thin layers of a TDI-based polyurethane foam to encourage stabilization by cell ingrowth. Residual toluene diamine (TDA) was found in prepolymer-based polyurethanes at the part-per-biUion level and, more importantly, hydrolysis that would lead to the release of more TDA in vivo was suspected. 

Smith HR. Do silicone breast implants cause autoimmune rheumatic diseases Journal of Biomaterials Science, Polymer Edition 1995, 7, 115-121. 

Figure 7.10 Images of a section from a worn silicon-breast implant envelope (a) T2-weighted imaged, (b) image of dipolar encoded longitudinal magnetisation...

There is a possible association between silicone breast implants and underlying connective tissue diseases (9,28-30). 

In an evaluation of the frequency and clinical characteristics of the underlying connective tissue disorders associated with silicone breast implants, 300 women with silicone breast implants were studied (45). In addition to a history and physical examination, C reactive protein, rheumatoid factor, and autoantibodies were determined. Criteria for fibromyalgia and/or chronic fatigue syndrome were met by 54% connective tissue diseases were detected in 11% and undifferentiated connective tissue disease or human adjuvant disease in 10.6%. A variety of disorders, such as angioedema, frozen shoulder, and a multiple sclerosis-like syndrome, were also found. Several other miscellaneous conditions, including recurrent and unexplained low grade fever, hair loss, skin rash, symptoms of the sicca sjmdrome, Rajmaud s phenomenon, carpal tunnel syndrome, memory loss, headaches, chest pain, and shortness of breath were also seen. Of 93 patients who underwent explantation, 70% reported improvement in their systemic symptoms. 

Bridges AJ, Conley C, Wang G, Burns DE, Vasey FB. A clinical and immunologic evaluation of women with silicone breast implants and symptoms of rheumatic disease. Ann Intern Med 1993 118(12) 929-36. 

Suzuki K, Aoki M, Kawana S, Hyakusoku H, Miyazawa S. Metastatic silicone granuloma lupus miliaris disseminatus faciei-like facial nodules and sicca complex in a silicone breast implant recipient. Arch Dermatol 2002 138(4) 537-8. 

Teuber SS, Ito LK, Anderson M, Gershwin ME. Silicone breast implant-associated scarring dystrophy of the arm. Arch Dermatol 1995 131(l) 54-6. 

Vojdani A, Brautbar N, Campbell AW. Antibody to silicone and native macromolecules in women with silicone breast implants. Immunopharmacol Immunotoxicol 1994 16(4) 497-523. 

Vojdani A, Campbell A, Brautbar N. Immune functional impairment in patients with clinical abnormalities and silicone breast implants. Toxicol Ind Health 1992 8(6) 415-29. 

Cuellar ML, Gluck O, Molina JF, Gutierrez S, Garcia C, Espinoza R. Silicone breast implant—associated musculoskeletal manifestations. Clin Rheumatol 1995 14(6) 667-72. 

Despite of the silicon breast implant campaign which is a serious issue in the United States but evidently not in the rest of the world, the above statement on the environmental impact of silicones is also applicable to the impact on health of silicon medical devices and silicon implants, which are daily used in hospitals worldwide due to their excellent biocompatibility to human tissue and blood [11-13] There is also a long lasting experience clinically documented over decades on their reliability in specific applications. 

In the case of the silicone breast implant a claim was brought up that it effects the human immune system to cause a whole variety of connective tissues disorders. In fact, all documented scientific investigations, including several recent results from well recognized investigators, continue to show that there is no association between silicone and either typical or atypical tissue disease [14, 15]. 

In recent years, some of the symptoms of MCS have been reported to afflict two new populations -military veterans exhibiting Gulf War syndrome and women having silicone breast implants for esthetic reasons or for breast reconstruction after cancer surgery. 

Snyder JW (1997) Silicon breast implants Can emerging medical, legal, and scientific concepts be reconciled Journal of Legal Medicine 18 133. 

Bondurant S, Ernster V, Herdman R, Editors. Safety of silicone breast implants. Committee on the Safety of Silicone Breast Implants, Washington DC Institute of Medicine, 1999. 

Shons AR, Schubert W. Silicone breast implants and immune disease An overview. Ann Plast Surg 1992 28 491-501. 

There have been case-reports of a confirmed diagnosis of systemic sclerosis, rheumatoid arthritis, or systemic lupus erythematosus in patients with silicone breast implants (Silverstein et al., 1992 Sanchez-Guerrero et al., 1994 Cuellar et al., 1995 Field Bridges, 1996). However, no association between silicone breast implants and connective tissue disease has been seen in more than... 

Angell M (1997) Antipolymer antibodies, silicone breast implants, and fibromyalgia [letter]. Lancet, 349(9059) 1171-1172. 

Brown SL (2002) Epidemiology of silicone breast implants. Epidemiology, 13 S34-S39. 

Constant CM, Swaak AJ, Wiggers T, Wai RT, Van Geel AN (2000) First evaluation study of the Dutch Working Party on silicone breast implants (SBI) and the silicone-related symptom complex (SRSC). Clin Rheumatol, 19 458-463. 

De Jong WH, Goldhoom CA, Kallewaard M, Geertsma RE, van Loveren H, Bijlsma JWJ, Schouten JSAG (2002) Study to determine the presence of antipolymer antibodies in a group of Dutch women with a silicone breast implant. Clin Exp Rheumatol, 20(2) 151-160. 

De Jong WH, Kallewaard M, Goldhoorn CA, Verhoef CM, Bijlsma JWJ, Schouten JSAG, van Loveren H (2004) Long-term exposure to silicone breast implants does not induce antipolymer antibodies. Biomaterials, 25 1095-1103. 

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