DISTRIBUTION OF ORGANOSILICON POLYMERS IN AUGMENTATION MAMMAPLASTIES AT AUTOPSY

Silicone-containing breast implants have been used since 1963 for cosm etic augmentation and breast reconstruction. Currently, there is inten se debate regarding the extent and mechanism of migration of silicone from the area of implant. The current study compares tissue distributi on of organosilicon polymers between women with and without silicone b reast implants to determine the extent of silicone migration from brea st implants. Samples were collected at autopsy from 15 individuals wit h bilateral breast implants with no known history of chest trauma and from 14 age- and sex-matched controls. Capsule, breast, axillary lymph nodes, abdominal fat, liver, lung, and. spleen were collected for ana lysis of organosilicon con polymers by atomic absorption spectrometry and for examination by light microscopy. Blood was collected for analy sis of rheumatoid factor and antinuclear antibodies. Silicone was obse rved microscopically in at least one capsule section from all implant cases and in at least one lymph node in 8 of 15 implant cases. Silicon e was not observed in lymph nodes from control cases. Organosilicon po lymers were extracted from tissue using heptane, and the silicon conte nt of the extract was quantitated by atomic absorption spectrometry. S ilicon was detected in all capsules; statistically significant increas es of organosilicon polymers were measured in axillary lymph nodes, br east, and abdominal fat from individuals with silicone breast implants when compared with the nonimplant group. Measurable amounts of organo silicon polymers were found in tissues from the nonimplant group. Suit able blood specimens were analyzed for the presence of rheumatoid fact or and antinuclear antibodies. All nine implant cases tested were nega tive for the presence of antinuclear antibodies. Three implant cases w hich were tested for rheumatoid factor also were negative. We conclude that organosilicon polymers routinely migrate from the site of breast implantation to regional tissues near the implant site. Tissues from nonimplant cases often contained measurable amounts of organosilicon p olymers, and tissue distribution was variable within any single indivi dual; this is consistent with the widespread use and form of organosil icon polymers.