Silicone breast implant-related illness or breast implant-related “ASIA” syndrome: Expert consensus

Abstract

Introduction

Breast augmentation surgeries are very common, but in recent years there has been a growing interest in their possible relationship with the appearance of nonspecific symptoms and signs, as well as the development of autoimmune disorders. The lack of a consensus about the syndrome is a controversial issue for the scientific community and generates uncertainty among women with breast implants in Colombia.

Objective

To provide guidelines for the evaluation, approach, and follow-up of silicone breast implant-related disease, or ASIA syndrome, based on evidence and clinical expert opinion.

Methods

Experts from the Colombian Society of Rheumatology and the Colombian Society of Plastic Surgery and an independent methodological team developed a systematic literature review and consensus using a modified Delphi method.

Results

The evidence for an association between silicone breast implants and the development of symptoms, autoimmune or rheumatic diseases is limited, and a definitive causal relationship has not been demonstrated. The low certainty of the evidence is due to bias, study heterogeneity, and non-specific, self-reported symptoms. On this basis, 22 consensus statements were formulated, highlighting the importance of an individualized medical approach, comprehensive evaluation, and effective communication with patients about risks and expectations before implantation and explantation procedures.

Conclusions

Evaluation and therapeutic decisions in women with suspected silicone implant-associated disease should be based on available scientific evidence. Future research should explore the causality of the syndrome and improve disease characterization.