Silicone Breast Implants and Autoimmunity: A case report

Abstract

The impact of breast implants on the immune system has been debated since their introduction in the 1960s, linking silicone to systemic autoimmune diseases. Recent studies have shown that silicone gel can migrate from the implant capsule, triggering immune responses by proliferating immune cells and releasing cytokines, affecting T-cell function. Silicone particles can induce the release of IL-1β and activate the NALP3 inflammasome and B cells, causing an imbalance in regulatory T cells, responder T cells, and Th17 cells. A 41-year-old female patient with a history of breast implants presented with hyperpigmented, irregular, expanding lesions and was diagnosed withmorphea in 2017. The patient also experienced symptoms such as headaches, vertigo, polyarticular pain, dry skin, and fatigue. The medical history included silicone breast implants in 2005 (PIP brand, 395 cc) and 2014 (Silimed brand, 325 cc). The patient was diagnosed with psoriasis and Sjögren's syndrome in 2018, and ASIA syndrome in 2021 and subsequently underwent implant removal, leading to clinical improvement. The patient exhibited poliautoimmunity, with multiple autoimmune conditions. Postsurgery, the patient experienced controlled polyarticular pain, with no new skin plaques and improved clinical status. The temporal correlation between implant placement and autoimmune symptoms, alongside clinical improvement post-breast implant removal, supports the hypothesis that implants function as immune adjuvants. Genetic susceptibility and environmental factors, such as silicone exposure, likely contribute to this pathology. This case highlights the potential for silicone implants to act as immune adjuvants and highlights the importance of multidisciplinary approaches in diagnosing and treating patients with autoimmune manifestations and exposure to adjuvants.