Health symptoms and cosmetic silicone breast implants: A retrospective cohort study

Background: There has been a growing concern about a possible causal relationship between silicone breast implants (SBIs) and health symptoms, referred to as breast implant illness. This study assessed the association between SBIs for cosmetic augmentation and health symptoms. Methods: This retrospective cohort study used the data from the Dutch Breast Implant Registry and Nivel Primary Care Database. A total of 688 women with cosmetic SBIs were age-matched with 1301 women without SBIs. The occurrence of 13 health symptoms presented in general practice was assessed 1 year before implantation until 3 years after implantation. Comparisons were made regarding the number of symptoms and general practice consultations, before and after implantation and between the two groups. Results: Women with SBIs were more likely to experience three or more distinct health symptoms and a combination of multiple symptoms with multiple consultations during follow-up than women without SBIs (adjusted OR 1.44, 95% CI 1.06 to 1.96; adjusted OR 1.44, 95% CI 1.04 to 2.00, respectively). Women with SBIs also had more than twice the likelihood of manifesting these outcomes in the second year after implantation compared to the first year before implantation (OR 2.13, 95% CI 1.27 to 3.57; OR 2.13, 95% CI 1.22 to 3.72, respectively). Conclusions: Women with cosmetic SBIs had increased odds of developing health symptoms after implantation compared to those before implantation and to women without SBIs. These results suggest an association between health symptoms and cosmetic SBIs that needs further research to explore whether there is causality or residual confounding.