Connective tissue disease and other rheumatic conditions following cosmetic breast implantation in Denmark

Objective: To examine the occurrence of connective tissue diseases (CTDs) a s well as ill-defined and other rheumatic conditions among Danish women wit h cosmetic silicone breast implants. Patients and Methods: A total of 2761 women with breast implants and 8807 c ontrol subjects were identified from plastic surgery private clinics and fr om public hospital plastic surgery departments. Women operated on at plasti c surgery private clinics were identified through the files of each clinic, while women operated on at public hospitals were identified using the nati onwide Danish National Registry of Patients. The control group consisted of women who underwent cosmetic surgery other than breast implantation or who only had a consultation. All women were followed up from January 1, 1977, through December 31, 1996, through the Danish National Registry of Patients for the occurrence of CTD as well as ill-defined and other rheumatic condi tions. For the study period January 1, 1977, through December 31, 1994, the Danish National Registry of Patients contains information on hospitalizati on only, whereas data on outpatient visits are included from 1995 on, thus improving the sensitivity of the data. The: implant and control groups were compared with the Danish population rates for CTD and ill-defined and othe r rheumatic conditions, and a direct comparison between the implant and con trol groups was also performed. Results: When compared with rates from the general population, no excess of definite CTD was observed in the implant cohorts. For ill-defined and othe r rheumatic conditions, statistically significant excesses of unspecified r heumatism were observed in both the implant and control cohorts when compar ed with national rates. A direct comparison between the implant and control cohorts found no material differences between the groups. Conclusions: The findings of this study support previous investigations and independent review panel conclusions that an association between silicone breast implants and definite CTDs is unlikely. The observation of an excess of unspecified rheumatism among women with implants and among control wome n suggests that women undergoing cosmetic plastic surgery have hospitalizat ion rates for this condition in excess of those from the general population .