Silicone Breast Implants and Injections

From DoctorMyhill
Jump to navigation Jump to search



I have now been consulted by over 300 patients with chronic ill health following silicone breast implants or injections. Silicone leaks out of the implant from the day it is implanted (so called "gel bleed"). Some leaked silicone is found immediately round the implant where a pseudo-capsule forms - this may be full of silicone granulomas. Some silicone is picked up by the reticulo-endothelial cells and distributed widely throughout the whole body. Silicone is tough molecule which cannot be broken down by any biological enzyme system. It is a plastic - plastic bags do not even rot down in a compost heap! However, in some patients the immune system tries to break down the silicone. This causes inflammation wherever the silicone ends up. Because the largest part of our body is made up of muscle, connective tissue and skin, I commonly see symptoms here. It is very common to hear patients complaining of "burning" pain. However, any part of the body may be affected.

As medical students we were – and are – taught that this is an inert plastic that is non-toxic. Whilst that may be true in the chemical sense, we now know it is not the case in the immunological sense. It is an immune adjuvant – so it switches on the immune system. Indeed, silicones were once used in vaccinations to ensure a good immune response to whatever was in the vaccine.

How does silicone get in the body?

With silicone I am not just looking for the obvious breast implant or silicone injections (siliconosis) - many other prostheses have biologically active materials. Examples include:

  • other breast implants - all breast implants, including saline ones, have silicone in them - often the outer shell is silicone,
  • testicular implants,
  • lens implants,
  • Norplant contraceptive device (silicone rods),
  • TMJ work,
  • facial contouring - chin implants etc,
  • meshes for hernia repairs or wound repairs
  • "sting" injection of teflon for treating urinary reflux in children
  • and many others

Problems with silicone implants

There are many problems with implants, of which the most obvious is reaction at the time of insertion. The majority of women who have silicone implants do not seem to react to the silicone - the immune system ignores it. However, for an unfortunate few the immune system is activated against the silicone. This can cause problems immediately after implantation when the body tries to get rid of the silicone. It does this by throwing up a fibrous capsule around the implant which then contracts, trying to squeeze the implant out. This is akin to the mechanism by which the body gets rid of any foreign body that gets into it, such as a thorn. In this event the implant goes hard and becomes painful. Surgeons often treat this by crushing the breast between their hands, either to rupture the implant or break the pseudo-capsule. However, this often creates just more problems. This technique is called external capsulotomy.

However, the long term effects are far more malign. This stems from the fact that silicone cannot be broken down by any enzyme system in the body, is engulfed by macrophages, carried to distant sites by embolisation and there it acts as an immune adjuvant, stimulating immune activity. This means that these patients may suffer from multisystem disease.

Therefore, we see dysregulation of the immune system with:

My clinical impression is that the silicone poisoned patients suffer more from pain (typically described as a burning pain) than those suffering from virally or OP induced CFS. I have concluded from my own observations that silicone causes a new disease unique to silicone but resembling other diseases - see below - "ASIA"

Mechanism of damage by silicone

It is well recognised that the silicone bleeds out of the implants very readily and is widely distributed throughout the body by the reticulo-endothelial system. Silicone leaks out as soon as the implants are put in. Silicone is well recognised as being an immune adjuvant and I suspect in susceptible individuals we get an inflammatory reaction against the silicone which results in multi-system disease. The Louisiana ruling on 19.8.97 showed that Dow Corning was developing silicone for use as an active pharmaceutical agent at the same time as when it was being declared "inert". See New York Times Article, 19.8.1997, "Dow Chemical Deceived Women On Breast Implants, Jury Decides"

There is no known mechanism by which silicone can be excreted from the body. Silicone leakage is accelerated when implants rupture, of which 50% do so by 12 years and 95% by 20 years.

In fact leakage of silicone could be worse than that: Dr Edward Melmed, a plastic surgeon from Dallas, told an FDA (the US’s Food & Drug Agency) panel that by 10 years after patients get them, 50% of silicone implants have ruptured, by 15 years, 72% and by 20 years, 94%. Meanwhile the US’s Institute of Medicine has reported that

‘Prevalence of rupture differing by brand of implant has been reported by Feng (IOM Scientific Workshop, 1998), and Peters and Francel have reported major differences in rupture for silicone gel implants of different vintages, up to 95% at 12 years’ implantation with thin shelled, 1972-mid 1980s implants (France l et al., 1998; Peters et al., 1996).’ 

See -

  • Francel TJ. Silicone-gel implant longevity (Abstract) In: Proceedings of 67th Annual Scientific Meeting of the American Society of Plastic and Reconstructive Surgeons, 1998.
  • Peters WJ, Smith D, Lugowski S. Failure properties of 352 explanted silicone gel implants. Canadian Journal of Plastic Surgery 1996; 4(1):55-58.

What causes these ruptures?

Most of these ruptures are spontaneous but some follow closed capsulotomy, road traffic accident or whatever. A Lancet paper (as far back as November 1997) recommended that all implants be replaced every 8 years - see Rupture of silicone-gel breast implants: causes, sequelae, and diagnosis. Silicone leakage can be a problem locally whereby the body throws up a scar capsule against the implant to try to prevent the silicone from leaking. As this scar contracts this causes local hardening of the breast, often with pain. Surgeons treat this by crushing the breast between their hands (often with no anaesthetic!) to rupture the scar capsule (this unproven, extremely painful procedure has been sanitised by giving it a name: closed capsulotomy). The implant may also be ruptured by this procedure. Once ruptured, the silicone may migrate in a lump to the axilla and brachial plexus causing pain and blockage of lymphatics, across the breast causing a mis-shapen breast (one patient had to have her nipples surgically re-sited), or down the chest wall.


ASIA or ‘autoimmune/ inflammatory syndrome induced by adjuvants’ is the name now given to this spectrum of illness where symptoms are caused by an (immune) adjuvant, such as silicone.

As ever, the science is slowly – too slowly for patients – catching up with clinical experience. Here are 2 papers that discuss this newly defined, but well known to patients, condition -

Second generation effects

There is every reason to expect silicone to cross the placenta into the unborn child. The effects of this are uncertain. Professor Shanklin has looked at a group of 190 women who had babies before and after their implant. There were 127 pre-implant children of which 100 were in good health, 27 in fair health (minor transient problems) and none sick. This compares to 252 post-implant children, of which 78 were in good health 81 in fair health with 93 WHO WERE MORE SERIOUSLY ILL (compares to none in the pre-implant group!). This experience certainly accords with what I am seeing in my patients. See The Guardian newspaper, January 2012, "Breast implants: 'There are some very frightened women'"

Professor Shanklin wrote extensively about the dangers of silicone as far back as 1998 - see The immunopathology of siliconosis - History, clinical presentation, and relation to silicosis and the chemistry of silicon and silicone


  • Explantation and Plaquenil. I have had direct contact with Professor Shanklin and he has been most helpful with clinical management. We had a long meeting at the Royal Society of Medicine where I could pick his brains. The priority is to have the silicone removed by a surgeon skilled in explantation. However, the problem with explantation is that it is thought to stir up a reaction against silicone and patients often see a worsening of their symptoms which may last up to 3 years. Professor Shanklin tells me that reactions against silicone are medicated by T cells and interleukin 2. He has tried Plaquenil 200mgs twice daily for 30 days before and 60 days after surgery and believes this damps down the T cell activity and prevents this post operative flare. Plaquenil is a standard immunosuppressive drug often used to treat rheumatoid arthritis and systemic lupus erythematosis. It is a fairly benign drug and it is felt that for short term treatment no special monitoring is required although it is probably medically prudent to check a white cell count and eye test before and during treatment. Explantation needs to be done by a skilled surgeon aware of the need not to rupture the capsule inadvertently. Furthermore, the scar capsule also needs removing because it will be impregnated with silicone. Insist on being given the implant after surgery and don't allow the surgeon to refuse to show you your implant! I had one patient who was told the implant was removed intact, but it was "scrubbed" to make it look better and ruptured in that process, therefore it was not available to be seen! Let's face it - you've paid for it - it belongs to you!

Here is a list of Recommended UK Explant surgeons from the UK Breast Implant Illness and Healing Support Facebook Group:

Recommended UK Explant Surgeons

  • Detoxing. Unfortunately, there is no mechanism by which silicones can be excreted from the body. I am not aware of any method of detoxing to facilitate this. One simply has to put in place all of the above measures and hope that the immune system eventually loses interest in silicone and "burns itself out". This is my experience treating women who are able to hold the above regimes in place.

Related Articles

External Links


Sarah Myhill Limited :: Registered in England and Wales :: Registration No. 4545198
Registered Office: Upper Weston, Llangunllo, Knighton, Powys, Wales LD7 1SL, UK. Tel 01547 550331 | Fax 01547 550339