Systemic Inflammatory Reaction After Silicone Breast Implant

• Published in: Aesthetic plastic surgery 2011-10, Vol.35 (5), p.789-794
• Main Authors: Silva, Maira M., Modolin, Miguel, Faintuch, Joel, Yamaguchi, Camila M., Zandona, Cintia B., Cintra, Wilson, Fujiwara, Haroldo, Curi, Rui, Gemperli, Rolf, Ferreira, Marcos C.
• Format: Article
• Language: English
• Subjects: Abdominal Fat - transplantation; Adolescent; Adult; Autoantibodies - analysis; Autoantibodies - immunology; Breast Implantation - adverse effects; Breast Implantation - methods; Breast Implants - adverse effects; C-Reactive Protein - metabolism; Case-Control Studies; Cohort Studies; Female; Follow-Up Studies; Humans; Inflammation - epidemiology; Inflammation - etiology; Inflammation - physiopathology; Inflammation Mediators - analysis; Inflammation Mediators - metabolism; Medicine; Medicine & Public Health; Original Article; Otorhinolaryngology; Plastic Surgery; Postoperative Complications - physiopathology; Postoperative Complications - surgery; Prosthesis Failure; Reference Values; Reoperation - methods; Risk Assessment; Silicone Gels - adverse effects; Systemic Inflammatory Response Syndrome - chemically induced; Systemic Inflammatory Response Syndrome - physiopathology; Systemic Inflammatory Response Syndrome - therapy; Young Adult
• ISSN: 0364-216X; 1432-5241
• DOI: 10.1007/s00266-011-9688-x

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/m 2 , 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.