NIEUW medisch onderzoek uitgelicht 

Abstract

Breast Implant Illness (BII) is characterized by a cluster of systemic and local symptoms affecting a subset of women with silicone breast implants. While symptom improvement is frequently observed following implant removal, the underlying mechanisms remain poorly understood, and the absence of reliable biomarkers complicates clinical decision-making. Here, we investigate inflammatory protein profiles in 43 women with BII, comparing pre- and post-explantation levels using the Olink Target 96 Inflammation panel and Meso Scale Discovery technology for absolute quantification. Sixteen inflammatory proteins, including MCP-1, CD8A, and CCL11, were elevated post-explantation, with FGF-19 showing the most pronounced increase (64%). FGF-19 levels increased from a median of 136 pg/mL to 195 pg/mL (p = 0.001), comparable to levels in women with silicone breast implants but no BII. We propose that explantation may alleviate FGF-19 signaling disruption, restoring its metabolic benefits. These findings suggest FGF-19 as a potential diagnostic and therapeutic marker for BII, warranting further investigation. 

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Abstract 2024 >> 

Silicone-based breast implants are commonly used, but there are concerns about their long-term safety. While implantation results in the formation of a periprosthetic tissue that isolates the implant from the rest of the host body, silicone can leak and reach surrounding tissues. We combined histological analysis and gene expression profiling (RNA sequencing) of samples from human patients with silicone breast implants with different fillers (silicone or serum), surface topographies and/or shell rupture, and performed systematic cross-comparisons. Our study shows that exposure to silicone gel filler, even in clinically asymptomatic cases, induces an immune response. This response includes the expression of markers associated with various autoimmune diseases. This study provides the first biological evidence of an association between silicone implants and autoimmune markers, highlighting the need for further research and stricter implant safety regulations. We suggest that implant design factors, such as filler type and surface texture, may influence the inflammatory response. Re-evaluation of existing clinical trials is warranted to investigate the association between implant characteristics and potential health risks.

OPINION article

Front. Glob. Womens Health, 17 May 2024 Sec. Quality of Life Volume 5 - 2024 | https://doi.org/10.3389/fgwh.2024.1359106

This article is part of the Research Topic  Breast Implants and Quality of Life

citaat:   

Turning tables

In the annals of medical history, the pursuit of innovation has often led to unforeseen repercussions. The predominant narrative of assumed breast implant safety is challenged by substantial device failure, emerging implant-related cancers, and poorly understood BII symptoms, skewing the risk-benefit equation. It becomes prudent to apply the precautionary principle when assessing the trade-off between the benefits and the risks associated with breast implants. This principle asserts that in the absence of scientific consensus, the burden of proof falls on those advocating for a policy or action that could cause harm to the public. Our argument advocates for public safety prioritization, pressing all regulatory bodies to re-evaluate breast implant safety and promote the exploration of safer alternatives."

Publication date: september 2023  

Case report

Abstract

Background

Breast augmentation with implants is one of the most popular cosmetic surgery operations performed worldwide. Complications of breast implants are well recognized, and include capsular contracture, implant rupture, and infrequently distant migration of silicone, resulting in siliconoma. Distant migration of silicone can present many years after implantation with a wide variety of signs and symptoms.

Objectives

The aim of this study was to describe the authors’ experience of orbital silicone migration and to review the literature describing documented cases of distant silicon migration from breast implants, both ocular and nonocular.

Methods

In January 2022, a case of breast implant augmentation presented with silicone migration into the right orbit. This rare case was monitored and diagnosed with ocular muscle palsy and diplopia. Here, the authors present the patient's presenting complaint, symptomatology, working investigations, and outcomes. A comprehensive report of all available cases of distant silicone migration is presented along with their associated complications and more specifically ocular silicone migrati on.

Results

Systemic migration of silicone from breast implants to the orbital region is extremely rare: a total of 4 previous cases of ocular silicone migration from breast implants have been described previously; the authors describe the fifth case herein.

Conclusions

Silicone implant rupture can present with a wide variety of clinical symptoms that may mimic different clinical pathologies. In every patient with a history of breast augmentation with silicone implants, the possibility of silicone migration should be always taken into consideration during the differential diagnosis process.

Bron 

Paolo Montemurro, Tommaso Pellegatta, Harry Burton, Georgios Pafitanis, Silicone Migration From Breast Implants: A Case of Ocular Siliconoma and Literature Review, Aesthetic Surgery Journal, Volume 43, Issue 9, September 2023, Pages 972–977, https://doi.org/10.1093/asj/sjad086 

Publication date: 21 November 2023

Case Report

A 59-year-old woman presented with exertional dyspnea and cough. Her medical history was significant for bilateral mastectomy and chemoradiation for breast cancer at approximately 30 years of age. She subsequently had reconstructive surgery with saline breast implants, which were removed after 20 years. She was an ex-smoker, quitting 20 years previously. She did not report environmental or occupational exposures or intravenous drug use. Review of systems was negative for infectious or rheumatologic symptomatology. She maintained normal oxygen saturation on room air. Findings of her physical examination were unremarkable. Laboratory analysis, including hematologic, metabolic, inflammatory, and autoimmune studies, were within normal limits. Six-minute walk test did not demonstrate desaturation; oxygen saturation remained greater than 96%. Pulmonary function test demonstrated reduction in race corrected  lees verder >>