Silicone and autoimmunity.
BACKGROUND
Since the 1960s, silicone implants have been successfully used for breast augmentation and reconstruction. However, safety issues regarding the use of silicone have led to a moratorium by the US Food and Drug Administration between 1992 and 2006.


METHODS
To date, although the moratorium has been removed and women overwhelmingly prefer silicone over saline implants, local and systemic adverse effects still remain a concern.


RESULTS
Silicone-elicited inflammatory fibro-proliferative response and capsular contracture is irrefutable. Studies on silicone breast implants have not supported a relationship to carcinogenesis, whereas that to autoimmunity mainly to nondefined autoimmune phenomena seems very plausible. These silicone-related autoimmune adverse events termed 'siliconosis' are probably limited to a small minority of implanted patients.


CONCLUSIONS
Risk factors, such as characteristic environmental exposure and/or genetic predisposition, still require further elucidation. Similarly to antibacterial agents, texturized implants and Zafirlukast that were found to be beneficial in inhibiting fibro-proliferative response and capsular contracture, elucidating autoimmune-related risk factors might subsequently enable physicians to accurately predict long-term health status of silicone implant recipients.
Hajdu
Steven D
SD
The Zabludowicz Center for Autoimmune Diseases and Department of Medicine B, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Agmon-Levin
Nancy
N
Shoenfeld
Yehuda
Y
D001327:Autoimmune Diseases / Q000139:chemically induced*; D018427:Breast Implants / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012307:Risk Factors; D012828:Silicones / Q000009:adverse effects*
D012828:Silicones