Silicone Implants and Esophageal Dysmotility

Excerpt

The association between silicone breast implants and the development of rheumatic disease in their recipients has been suggested by a growing number of case reports.^1,2 Although prospective studies of implant recipients are awaited to confirm and quantify the risk of autoimmune disease associated with silicone breast prostheses, available evidence was considered sufficient to prompt the Food and Drug Administration's January 1992 request for a voluntary moratorium on further implantation of these devices and subsequent policy restricting implant availability to controlled, clinical trials. A variety of rheumatologic diseases have been reported among implant recipients, with a high proportion of patients displaying a sclerodermalike illness. Pathogenetic mechanisms are unknown. Bleeding of silicone out of implants into periprosthetic tissues, as well as migration to more distant sites including regional lymphoid tissue, is known to occur. The potential for initiating a systemic immune response therefore exists, although most women with silicone breast implants