The association of silicone implants with autoimmune disease is comprehensively reviewed and four new cases presented. In some instances of reported cases there appears to be a cause-and-effect relationship between silicone gel implants and the onset of autoimmune diseases, although in most cases the disease appears to be more likely the expected occurrence rate in females of this age group. Basic criteria for establishing a possible causative relationship are presented.
Get full access to this article
View all access options for this article.
References
1.
EllenbogenREllenbogenRRubinL: Injectable fluid silicone therapy—human morbidity and mortality. JAMA234:308, 1975.
2.
FerrieraMCSpinaVInyaK: Changes in the lung following injections of silicone gel. Brit J Plast Surg28:173, 1975.
3.
Ben-HurNBallantyneDLReesTD: Local and systemic effects of dimethylpolysiloxane fluid in mice. Plast Reconstr Surg39:423, 1967.
4.
ReesTDBallantyneDLSeidmanI: Visceral response to subcutaneous and intraperitoneal injections of silicone in mice. Plast Reconstr Surg39:402, 1967.
5.
ChristieAJWeinbergerKADietrichM: Silicone lymphadenopathy and synovitis complications of silicone elastomer finger joint prostheses. JAMA237:308, 1975.
HausnerRJSchoenFJPiersonKK: Foreign body reaction to silicone gel in axillary lymph nodes after an augmentation mammaplasty. Plast Reconstr Surg62:381, 1978.
8.
KircherT: Silicone lymphadenopathy—a complication of silicone elastomer finger joint prostheses. Human Pathol11:240, 1980.
9.
AndrewsJM: Cellular behavior to injected fluid: A preliminary report. Plast Reconstr Surg38:581, 1966.
10.
BarkerDERetskyMISchultzSL: “Bleeding” of silicone from bag-gel breast implants, and its clinical relation to fibrous capsule reaction. Plast Reconstr Surg61:836, 1978.
11.
BrodyGJ: Fact and fiction about breast implants “bleed.”Plast Reconstr Surg60:615, 1977.
12.
McGrathMH: Burkhardt BR: The safety and efficacy of breast implants for augmentation mammaplasty. Plast Reconstr Surg74:550, 1984.
13.
PriceJEBarkerDE: Initial clinical experiences with “low bleed” breast implants. Aesthet Plast Surg7:255, 1983.
14.
RudolphR: Myofibroblasts and free silicone around breast implants. Plast Reconstr Surg62:185, 1978.
15.
BakerJLJrLeVierRRSpielvogelDE: Positive identification of silicone in human mammary capsular tissue. Plast Reconstr Surg69:56, 1982.
16.
HeggersJP: Biocompatibility of silicone implants. Ann Plast Surg11:38, 1983.
17.
ChaplinCH: Loss of both breasts from injections of silicone (with additive). Plast Reconstr Surg44:447, 1969.
18.
LaveyEBPearlRM: Inflammation in a silicone-induced granuloma caused by a tuberculosis skin test. Plast Surg7:152, 1981.
19.
LightermanI: Silicone granuloma of the penis. Plast Reconstr Surg53:517, 1976.
20.
Ortiz-MonasterioFTrigosI: Management of patients with complications from injections of foreign material into the breasts. Plast Reconstr Surg50:42, 1972.
21.
ParsonsRWTheringHR: Management of the silicone injected breast. Plast Reconstr Surg60:534, 1977.
22.
PearlRMLaubDRKaplanEN: Complications following silicone injections for augmentation of the face. Plast Reconstr Surg61:888, 1978.
23.
SymmersWC: Silicone mastitis in “topless” waitresses and some other varieties of foreign body mastitis. Brit Med13:19, 1968.
24.
WilkieTF: Late development of granuloma after liquid silicone injections. Plast Reconstr Surg60:179, 1977.
25.
McGrathMHBurkhardtBR: The safety and efficacy of breast implants for augmentation mammoplasty. Plast Reconstr Surg74:550, 1984.
26.
SpeirsACBloeksmaR: New implantable silicone rubbers: Experimental evaluation of tissue response. Plast Reconstr Surg31:166, 1963.
27.
BrodyGS: Scleroderma after silicone augmentation mammaplasty. JAMA260:3008, 1988.
28.
ErasmusL: Scleroderma in gold miners in the Witwatersand with particular reference to pulmonary manifestations. S Afr J Lab Clin Med3:209, 1957.
29.
HausteinV: Progressive systemic sclerosis with silicosis in the German Democratic Republic. In Systemic Sclerosis (Scleroderma). BlackCMyersA, (eds.). New York: Gower Medical Publsihing, 1985, pp. 138–141.
30.
ZiskindM: Silicosis in shipyard sandblasters. Environ Res2:237, 1976.
31.
CzirjakLSzegediG: Benzene exposure and systemic sclerosis. Ann Intern Med107:118, 1987.
32.
WalderB: Do solvents cause scleroderma?Internat J Dermatol22:157, 1983.
33.
YamakageAIshikawaH: Generalized morphealike scleroderma occurring in people exposed to organic solvents. Dermatologica165:186, 1982.
34.
Findt-HansenHIsagerH: Scleroderma after occupational exposure to trichlorethylene and trichlorethane. Acta Derm Venereol (Stockholm)67:263, 1987.
35.
LockeyJ: Progressive systemic sclerosis associated with exposure to trichlorethylene. J Occup Med29:493, 1987.
36.
SparrowG: A connective tissue disorder similar to vinyl chloride disease in a patient exposed to perchlorethylene. Clin Derm2:17, 1977.
37.
Langauer-LewewickaH: Vinyl chloride disease: Neurological disturbances. Int Arch Occup Environ Health52:151, 1983.
38.
LipskyPE: Rheumatoid arthritis. In Harrison's Principles of Internal Medicine. BraunwaldE, (eds.). New York: McGraw-Hill, 1987, p. 1423.
39.
HahnBH: Systemic lupus erythematosis. In Harrison's Principles of Internal Medicine. BraunwaldE, (eds.). New York: McGraw-Hill, 1987, p. 1418.
40.
KurlandLT: Epidemiologic features of diffuse connective tissue disorders in Rochester, Minnesota, 1951 through 1967, with special reference to systemic lupus erythematosis. Mayo Clin Proc44:649, 1969.
41.
MedsgerTAJrMasaiAT: Epidemiology of progressive systemic sclerosis. Clin Rheum Dis5:15, 1979.
42.
MiyoshiK: Hypergammaglobulinemia by prolonged adjuvanticity in man. Disorders developed after augmentation mammaplasty. Japan Med J2122:9, 1964.
43.
YoshidaK: Postmammaplasty disorder as an adjuvant disease of man. Shikiku Acta Med29:318, 1973.
44.
KumagiYAbeCShiokawaY: Scleroderma after cosmetic surgery. Four cases of human adjuvant disease. Arth Rheum22:532, 1979.
45.
FockKMFengPHTeyBH: Autoimmune disease developing after augmentation mammaplasty. Report of 3 cases. J Rheumatol11:98, 1984.
46.
KumagaiY: Clinical spectrum of connective tissue disease after cosmetic surgery. Arth Rheum27:1, 1984.
47.
OkanoYNishikaiMSatoA: Scleroderma, primary biliry cirrhosis, and Sjogren's syndrome after cosmetic breast augmentation with silicone injection: A case report of possible human adjuvant disease. Ann Rheum Dis43:520, 1984.
48.
SergottTJ: Human adjuvant disease, possible autoimmune disease after silicone implantation: A review of the literature, case studies, and speculation for the future. Plast Reconstr Surg78:104, 1986.
49.
ByronMAVenningVAMowalAG: Postmammaplasty human adjuvant disease. Brit J Rheumatol23:227, 1984.
50.
LeRoyEC: Breast augmentation—Is there a risk?J S Carolina Med Assoc86:556, 1990.
51.
UretskyBF: Augmentation mammaplasty associated with severe systemic illness. Ann Plast Surg3:445, 1977.
52.
Van NunenSAGatenbyPABastenA: Postmastectomy connective tissue disease. Arth Rheum25:694, 1982.
53.
BaldwinCMJrKaplanEN: Silicone-induced human adjuvant disease?Ann Plast Surg10:270, 1983.
EndoLP: Silicone and rheumatic diseases. Sem Arth Rheum17:112, 1987.
56.
BrozenaSJ: Human adjuvant disease following augmentation mammoplasty. Arch Dermatol124:1383, 1988.
57.
GylbertL: Results of subglandular breast augmentation using a new classification method—18-year follow-up. Scand J Plast Reconstr Surg23:133, 1989.
58.
VargaJSchumacherRJimenezA: Systemic sclerosis after augmentation mammaplasty with silicone implants. Ann Intern Med111:377, 1989.
59.
SpieraH: Scleroderma after silicone augmentation mammaplasty. JAMA260:236, 1988.
60.
WeismanMA: Connective-tissue disease following breast augmentation: A preliminary test of the human adjuvant hypothesis. Plast Reconstr Surg82:626, 1988.
61.
MarikPEKarkALZambakidesA: Scleroderma after silicone augmentation mammaplasty. S Afr Med J77:212, 1990.
62.
SahnEE: Scleroderma following augmentation mammaplasty. Arch Dermatol126:1198, 1990.
63.
BarnesCG: Rheumatoid arthritis. In Mason and Currey's Clinical Rheumatology. CurreyHLF, (ed.). Philadelphia: J.B. Lippincott Co., 1980, p. 30.