Aesthetic Plastic Surgery

, Volume 35, Issue 5, pp 789–794 | Cite as

Systemic Inflammatory Reaction After Silicone Breast Implant

  • Maira M. Silva
  • Miguel Modolin
  • Joel Faintuch
  • Camila M. Yamaguchi
  • Cintia B. Zandona
  • Wilson CintraJr.
  • Haroldo Fujiwara
  • Rui Curi
  • Rolf Gemperli
  • Marcos C. Ferreira
Original Article

Abstract

Background

Systemic inflammation after augmentation mammaplasty with modern silicone implants is not currently recognized. In a prospective controlled study, C-reactive protein and other variables were monitored, aiming to test this hypothesis in a young cohort of patients.

Methods

Females (18-30 years old, BMI = 18.5-30 kg/m2, N = 52) were consecutively recruited for breast implant (n = 24, Group I) and for abdominal liposuction (n = 28, Group II/Controls). Patients were interviewed at baseline and followed until 6 months after operation. Variables included demographic and clinical information, surgical outcome, inflammatory markers and autoantibodies.

Results

Operations were well tolerated, without surgical or infectious complications. Mean prosthesis size was 258 ± 21 ml (range = 220-280) and mean aspirate of liposuction was 1972 ± 499 ml (range = 1200-3000). Preoperative, 2-month, and 6-month C-reactive protein concentrations for breast implant patients were 1.3 ± 1.2, 4.8 ± 3.0, and 4.3 ± 6.4 mg/l and for liposuction 3.5 ± 2.7, 3.5 ± 2.1, and 2.2 ± 2.2 mg/l, respectively. Change at 2 months was significant (p = 0.001). Autoantibody investigation failed to reveal remarkable aberrations, except for anticardiolipin elevation, which was nearly symmetrical in the two groups.

Conclusion

C-reactive protein levels increased after operation and correlated with proinflammatory and procoagulatory indices. A mild increase in anticardiolipin IgM occurred but differences between populations were lacking. Despite excellent cosmetic outcomes and lack of complications, acute phase reaction could signal ongoing immunogenicity of silicone and long-term monitoring is recommended.

Keywords

Augmentation mammaplasty Silicone breast implant Inflammatory reaction Autoantibodies C-reactive protein Cosmetic breast surgery 

References

  1. 1.
    Noone RB (1997) A review of the possible health implications of silicone breast implants. Cancer 79:1747–1756PubMedCrossRefGoogle Scholar
  2. 2.
    Hölmich LR, Vejborg IM, Conrad C, Sletting S, Høier-Madsen M, Fryzek JP, McLaughlin JK, Kjøller K, Wiik A, Friis S (2004) Untreated silicone breast implant rupture. Plast Reconstr Surg 114:204–214PubMedCrossRefGoogle Scholar
  3. 3.
    Narins RS, Beer K (2006) Liquid injectable silicone: a review of its history, immunology, technical considerations, complications, and potential. Plast Reconstr Surg 118(3 Suppl):77S–84SPubMedCrossRefGoogle Scholar
  4. 4.
    Spear SL, Jespersen MR (2010) Breast implants: saline or silicone? Aesthet Surg J 30:557–570PubMedCrossRefGoogle Scholar
  5. 5.
    Bondurant S, Ernster V, Herdman R (eds) (1999) Institute of Medicine (US) Committee on the Safety of Silicone Breast Implants: safety of silicone breast implants. National Academies Press, WashingtonGoogle Scholar
  6. 6.
    Niechajev I, Jurell G, Lohjelm L (2007) Prospective study comparing two brands of cohesive gel breast implants with anatomic shape: 5-year follow-up evaluation. Aesthet Plast Surg 31:697–710CrossRefGoogle Scholar
  7. 7.
    Psillakis JM, Facchina PH, Kharmandayan P, Trillo L, Canzi WC, Aguiar HR (2010) Review of 1,477 breast augmentation payients using PERTHESE silicone implants. Aesthet Plast Surg 34:11–15CrossRefGoogle Scholar
  8. 8.
    Schmidt A, Bengtsson A, Tylman M, Blomqvist L (2007) Pro-inflammatory cytokines in elective flap surgery. J Surg Res 137:117–121PubMedCrossRefGoogle Scholar
  9. 9.
  10. 10.
    Anderson JM, Rodrigues A, Chang DT (2008) Foreign body reaction to biomaterials. Semin Immunol 20:86–100PubMedCrossRefGoogle Scholar
  11. 11.
    Wyatt LE, Sinow JD, Wollman JS, Sami DA, Miller TA (1998) The influence of time on human breast capsule histology: smooth and textured silicone-surfaced implants. Plast Reconstr Surg 102:1922–1931PubMedCrossRefGoogle Scholar
  12. 12.
    Siggelkow W, Faridi A, Spiritus K, Klinge U, Rath W, Klosterhalfen B (2003) Histological analysis of silicone breast implant capsules and correlation with capsular contracture. Biomaterials 24:1101–1109PubMedCrossRefGoogle Scholar
  13. 13.
    Petzold C, Rubert M, Lyngstadaas SP, Ellingsen JE, Monjo M (2011) In vivo performance of titanium implants functionalized with eicosapentaenoic acid and UV irradiation. J Biomed Mater Res A 96:83–92PubMedGoogle Scholar
  14. 14.
    Bond JS, Duncan JA, Mason T, Sattar A, Boanas A, O’Kane S, Ferguson MW (2008) Scar redness in humans: how long does it persist after incisional and excisional wounding? Plast Reconstr Surg 121:487–496PubMedCrossRefGoogle Scholar
  15. 15.
    U.S. FDA (2010) Medical devices, breast implants. Available at www.fda.gov/cdrh/breastimplants/labeling/mentor_patient_labeling_5900.html#9. Accessed 27 Dec 2010
  16. 16.
    Goncalves WL, Graceli JB, Santos RL, Cicilini MA, Bissoli NS, Abreu GR, Moysés MR (2009) Ultrasound lipoclasia on subcutaneous adipose tissue to produce acute hyperglycemia and enhance acute inflammatory response in healthy female rats. Dermatol Surg 35:1741–1745PubMedCrossRefGoogle Scholar
  17. 17.
    Klein S, Fontana L, Young VL, Coggan AR, Kilo C, Patterson BW, Mohammed BS (2004) Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med 350:2549–2557PubMedCrossRefGoogle Scholar
  18. 18.
    Levitsky J, Freifeld A, Lyden E, Stoner J, Florescu D, Langnas A, Brian Stevens R, Hardiman P, Hill L, Kalil AC (2009) Evaluation of the coagulation and inflammatory responses in solid organ transplant recipient and donors. Clin Transplant 23:943–950PubMedCrossRefGoogle Scholar
  19. 19.
    Shanklin DR, Smalley DL (1999) Dynamics of wound healing after silicone device implantation. Exp Mol Pathol 67:26–39PubMedCrossRefGoogle Scholar
  20. 20.
    Rabelo F, Oliveira CP, Faintuch J, Mazo DF, Lima VM, Stefano JT, Barbeiro HV, Soriano FG, Alves VA, Carrilho FJ (2010) Pro- and anti-inflammatory cytokines in steatosis and steatohepatitis. Obes Surg 20:906–912PubMedCrossRefGoogle Scholar
  21. 21.
    Morais AA, Faintuch J, Leal AA, Noe JA, Bertollo DM, Morais RC, Cabrini D (2011) Inflammation and biochemical features of bariatric candidates: does gender matter? Obes Surg 21(1):71–77PubMedCrossRefGoogle Scholar
  22. 22.
    Seyhan H, Kopp J, Beier JP, Vogel M, Akkermann O, Kneser U, Schwartz S, Hartmann A, Horch RE (2011) Smooth and textured silicone surfaces of modified gel mammary prostheses cause a different impact on fibroproliferative properties of dermal fibroblasts. J Plast Reconstr Aesthet Surg 64(3):e60–e66PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2011

Authors and Affiliations

  • Maira M. Silva
    • 1
  • Miguel Modolin
    • 1
  • Joel Faintuch
    • 2
    • 4
  • Camila M. Yamaguchi
    • 2
  • Cintia B. Zandona
    • 1
  • Wilson CintraJr.
    • 1
  • Haroldo Fujiwara
    • 3
  • Rui Curi
    • 3
  • Rolf Gemperli
    • 1
  • Marcos C. Ferreira
    • 1
  1. 1.Plastic Surgery ServiceSao Paulo University Medical SchoolSao PauloBrazil
  2. 2.Nutrition and Metabolism UnitSao Paulo University Medical SchoolSao PauloBrazil
  3. 3.Institute of Biomedical SciencesSao Paulo University Medical SchoolSao PauloBrazil
  4. 4.Hospital das Clinicas, II Surgical DivisionSão PauloBrazil

Personalised recommendations