Jj. Barnard et al., DISTRIBUTION OF ORGANOSILICON POLYMERS IN AUGMENTATION MAMMAPLASTIES AT AUTOPSY, Plastic and reconstructive surgery, 100(1), 1997, pp. 197-203
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.