Evaluation of the patient with silicone gel breast implants & rheumatic complaints

By utilizing a systematic approach to evaluate patients with

implants and musculoskeletal complaints, patients can be

categorized into either those with a true connective-tissue

disease (scleroderma, systemic lupus erythematosus, Sjogrens)

or those with nonspecific muscle and joint findings consistent

with fibromyalgia. This latter subgroup represents the

majority of patients who present with musculoskeletal

complaints and have no evidence of a serious connective-tissue

disease. Patients with silicone gel breast implants suffer

great anxiety and fear over the possible association of

implants and disease. Unfortunately, most of the information

provided to the patient is through the media, support groups,

or the legal system. Many patients are unable to evaluate this

issue in an objective fashion and present to the plastic

surgeon convinced that the implants are causing their

problems. Consultation with a rheumatologist interested in the

silicone gel implant controversy would serve to educate the

patient regarding the diagnosis, as well as provide an

independent source of information regarding the relationship

between implants and disease. Until proper case-control

studies are performed, the controversy over silicone gel

implants and connective-tissue disease will persist.

Cohen SB, Rohrich RJ

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