Ruptured Silicone Breast Implants

[TriciaT]

I wonder if you have any additional comments to that in your 14th edition in regard to silicone breast implants which may have ruptured or leaked, for women who are planning to breastfeed.

Tricia Taylor,
Sydney, Australia

[admin]

TriciaT:

As far as I know, there are no new data on the transmission of silicone content into human milk. Most silicones, when ingested, simply pass on out and are not absorbed due to their inertness. I still would not consider them a hazard to breastfeeding infants.
But we honestly don't know much about this. However, the polyacrylamide gel injections used in China, are horrific, should never be used in the first place, and could potentially be hazardous to a breastfed infant.
But these are polyacrylamide products, not silicon-based products. Big difference. Two abstracts enclosed suggest that silicon doesn't really enter the milk compartment.

Tom Hale


Plast Reconstr Surg. 1998 Aug;102(2):528-33.
Breast milk contamination and silicone implants: preliminary results using silicon as a proxy measurement for silicone.
Semple JL, Lugowski SJ, Baines CJ, Smith DC, McHugh A.
Source
Women's College Hospital and the Department of Surgery, University of Toronto, Ontario, Canada.
Abstract
In response to concerns about contamination of human breast milk from silicone gel-filled breast implants, and because silicon levels are assumed to be a proxy measurement for silicone, we compared silicon levels in milk from lactating women with and without implants. Two other sources of infant nutrition, cow's milk and infant formulas, were also analyzed for silicon. The survey took place at the Breast-feeding Clinic at Women's College Hospital in Toronto. A convenience sample of lactating women, 15 with bilateral silicone gel-filled implants and 34 with no implants, was selected. Women with foam-covered or saline implants or with medically related silicone exposures were ineligible. Collection of samples was scrupulously controlled to avoid contamination. Samples were prepared in a class 100 "ultraclean" laboratory and analyzed using graphite furnace atomic absorption spectrophotometry. Silicon levels were analyzed in breast milk, whole blood, cow's milk, and 26 brands of infant formulas. Comparing implanted women to controls, mean silicon levels were not significantly different in breast milk (55.45 +/- 35 and 51.05 +/- 31 ng/ml, respectively) or in blood (79.29 +/- 87 and 103.76 +/- 112 ng/ml, respectively). Mean silicon level measured in store-bought cow's milk was 708.94 ng/ml, and that for 26 brands of commercially available infant formula was 4402.5 ng/ml (ng/ml = parts per billion). We concluded that lactating women with silicone implants are similar to control women with respect to levels of silicon in their breast milk and blood. Silicon levels are 10 times higher in cow's milk and even higher in infant formulas.
PMID: 9703094 [PubMed - indexed for MEDLINE]


Plast Reconstr Surg. 2007 Dec;120(7 Suppl 1):123S-128S.
Breast-feeding and silicone implants.
Semple JL.
Source
Division of Plastic Surgery, Women's College Hospital, Toronto, Ontario, Canada. john.semple@wchospital.ca
Abstract
BACKGROUND:
Despite the overwhelming advantages of breast-feeding, there is a persistent concern that maternal exposure to chemical contaminants may result in contamination of breast milk and have an effect on the child's growth and development. A parallel concern regarding lactation in women with silicone implants over the past years has led to confusion and anxiety relating to the potential risks to the child.
METHODS:
The author reviewed the facts and issues as he knows them, including biomaterials, lactation toxicology, and a previous study where no difference was found in silicon (a proxy measurement of silicone) in women breast-feeding with silicone implants and those without.
RESULTS:
In the author's previous study, he compared women with implants to women without implants as controls and showed that mean silicon levels were not significantly different in breast milk (55.45 +/- 35 and 51.05 +/- 31 ng/ml, respectively) or in blood (79.29 +/- 87 and 103.76 +/- 112 ng/ml, respectively). However, silicon levels in alternative methods of infant nutrition were much higher. The mean silicon level measured in store-bought cow's milk was 708.94 ng/ml, whereas that for 26 brands of commercially available infant formula was 4402.5 ng/ml.
CONCLUSIONS:
In this review, the author looked only at silicon/silicone and did not address other potential contaminants that may be associated with silicone gel or the elastomer shell. This report may provide plastic surgeons and other healthcare workers with information regarding silicon/silicone for discussion with women with gel implants who are contemplating breast-feeding.
PMID: 18090822 [PubMed - indexed for MEDLINE]