Long term health effects of breast augmentation: A review

In this paper we have reviewed the existing scientific evidence with regard to long term hearth effects of breast implants. Two areas of concern have been voiced in the literature. Firstly the fear of an increased risk of cancer, specifically breast cancer, after cosmetic augmentation and secondly the potential relationship with the development of connective tissue disorders. In regard to the potential increased risk of breast cancer we conclude that no scientific evidence exists for a cause-effect relationship between silicone-gel filled implants and breast cancer. In fact all epidemiologic studies have found lower than expected risk estimates. Although some early studies have suggested that the presence of implants cause a delay in diagnosis and thus lead to a worse survival and prognosis, the evidence for this is unconvincing. In the large scale cohort studies no detrimental effect on survival was found. Data on the possible risk difference for other cancers are too scarce to permit a firm conclusion. With respect to connective tissue disorders, we conclude that the epidemiologic studies reported to date do not support a cause-effect relationship between silicone implants and connective tissue disorders. Some circumstantial evidence, such as the presence of autoimmune phenomena, granuloma formation and a distinct HLA phenotype in women with dermatomyositis after implantation, is available indicating that a plausible biologic mechanism could exist. Overall, however, the evidence does not permit the conclusion that silicone-gel filled implants cause connective tissue disorders.