Even without visible rupture, silicone breast implants release particles that trigger an immune response and activate markers associated with autoimmune diseases. This is revealed by a groundbreaking study conducted by an interdisciplinary team of chemists, biologists, and physicians, published in the journal
Biomaterials.
Findings that challenge the safety of these implants and call for a reassessment of associated risks.
Since their introduction in 1962, silicone breast implants have been at the center of scientific debate. Officially deemed safe by health authorities, they are nevertheless regularly suspected of being linked to various complications, including autoimmune diseases and chronic inflammatory reactions.
A study conducted by scientists from the Mulhouse Institute of Materials Science (CNRS/University of Haute Alsace), Besançon University Hospital, and the Institute of Genetics and Molecular and Cellular Biology (CNRS/INSERM/University of Strasbourg) has seriously reignited this debate.
From the moment of implantation, the body isolates this foreign object by forming a tissue barrier called periprosthetic tissue (simply put, the tissue surrounding the implant). It has been clearly demonstrated that the wall of breast implants is not a completely impermeable barrier. Three sources of silicone release into these tissues have been identified.
Surface erosion of the implant, which generates solid microparticles, the slow diffusion of silicone gel through the envelope—a phenomenon known as "gel bleed"—and finally implant ruptures, sometimes asymptomatic, which release significant amounts of gel into the body. Until now, biological proof of a direct link between silicone presence and an immune response in patients remained to be established. This has now been done, and the results are unequivocal.
The scientists analyzed the periprosthetic tissues of patients with implants, with or without rupture. They found that even without detectable leakage, the mere presence of silicone in the tissues triggers immune system activation. The tissues analyzed in the study show signs of chronic inflammation. The researchers observed an accumulation of macrophages, the immune system cells responsible for "cleaning up" foreign bodies. Unable to break down the silicone, they die and release their silicone content, leading to a chain reaction and persistent immune stress.
The team also conducted a transcriptomic analysis, studying the genes activated in the cells of the tissues surrounding the implants. They detected the activation of several genes associated with autoimmune diseases, such as rheumatoid arthritis, lupus, and certain chronic inflammations.
The intensity of the inflammatory reaction depends on the implant's texture: macrotextured implants, which have a rougher surface, induce a stronger immune response than microtextured or smooth models. This could explain why certain brands of implants are more frequently associated with complications, such as anaplastic large-cell lymphoma, a rare form of cancer linked to breast implants.
These results, published in the journal
Biomaterials, call into question the safety of silicone implants and highlight the need to reconsider their design and medical monitoring. Until now, silent ruptures (i.e., contained within the periprosthetic tissue envelope) were considered harmless, but this study provides biological evidence that silicone exposure, even without visible symptoms, could have long-term effects on the immune system. Through this study, the scientists call for a reassessment of past clinical studies to better understand the health impact of these implants.
Editor: AVR
Reference:
Breast implant silicone exposure induces immunogenic response and autoimmune markers in human periprosthetic tissue
Isabelle Pluvy, Eve Randrianaridera b , Ismail Tahmaz, Martine Melin, Florelle Gindraux, Céline Keime, Arnaud Ponche, Tatiana Petithory, Laurent Pieuchot, Karine Anselme & Isabelle Brigaud.
Biomaterials 2025
https://doi.org/10.1016/j.biomaterials.2024.123025