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Plastic Surgery/Breast Implants in 1983

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Question
My sister recently died of lupus complicated by pulmonary hypertension.  The Medical Examiner's report stated she had breast implants, but did not state whether they were silicone or saline.
We found out from her husband that the implants were placed in 1983.

There is no family history of lupus on both sides of the family, and I cannot locate any information stating whether implants were silicone or saline in 1983.

If the implants were silicone, is there a possibility that a rupture could have occurred that caused the lupus?  Thank you so very much for any information  Carol Ann

Answer
from Dr. Alan Engler
www.bodysculpture.com

Dear Carol Ann,

I am (obviously) very sorry for your loss.

The issue of breast implants and reported association with medical complications is a long and complicated one.  There have been many reports over the years of interactions such as this (silicone gel and auto-immune diseases) and there were many court settlements, reaching as much as $7 Billion Dollars, in the 1990s.

However, the overwhelming weight of scientific evidence is that these implants, whether silicone gel or saline (even the shell of a saline implant is made of silicone, though it's a stronger gel than the inside of a gel implant) do NOT cause auto-immune phenomena (or any other medical problems, including cancer).  Basically, while all of the reported medical problems (lupus, rheumatoid arthritis, cancer, etc) do occur in patients who have implants, they also occur in women who do not have implants.  And they occur at the same rate whether or not a woman has implants.  Based on that, the implants do not cause the phenomena.

This was was studied extensively by many experts (of which I am not one!) and you may want to look at a book from about twenty years ago, written by Marcia Angell, MD (the then editor of the New England Journal of Medicine), entitled "Science on Trial."  It reported on the problematic issue of non-scientific juries deciding emotional legal cases, and how the science can get lost in that process.

In sum, I am not aware of any credible scientific data that links implants, ruptured or not, to the causation of auto-immune diseases.  There could always be a few cases of - anything, actually - but that is not the same as hard and fast scientific data that can lead to conclusive evidence.  Auto-immune diseases are not necessarily familial or genetic (or at least not necessarily apparently so) and most likely is that that's the case for your sister.

Again, though - and hopefully needless to say - I am sorry,

Dr. E

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Alan M. Engler, MD, FACS

Expertise

Dr. Engler has answered over 6400 questions on social media sites, including over 3500 on AllExperts alone. His expertise includes breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts, lipomas, skin cancers, cysts, etc. Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction." Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), the Dr. Keith Ablow Show and Jerseylicious. Videos of his appearances are available on YouTube (search for "DR. ENGLER"), and his discussion of breast implants, also on YouTube is "How to Choose a Breast Implant." His website is www.bodysculpture.com. Follow Dr. Engler: @AlanEnglerMD

Experience

Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, as well as EyeScapes - Plastic Surgery of the Eyelids.

Education/Credentials
Dr. Engler graduated from Yale University (BA, Russian Studies) and the Columbia University College of Physicians and Surgeons (MD). He did his residency training in General Surgery and, after that, Plastic Surgery, at the Montefiore Medical Center in New York. He is on the faculty of the Albert Einstein College of Medicine in New York in the Departments of both Surgery (Plastic Surgery) and Medicine (Dermatology), and is a Special Lecturer in the Department of Dermatology at Columbia University in New York. He has admitting privileges at Beth Israel Medical Center and Montefiore Medical Center, both in New York.

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