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(Reuters Health) – Many women with silicone breast implants may have silicone gel leakage, according to a study of women in the Netherlands who had their implants revised or removed.

Researchers examined data on 389 women with silicone breast implants who had procedures to revise or remove the implants between January 1, 1986, and August 18, 2020. Overall, 384 women (98.8%) had silicone particles present in tissue and 337 (86.6%) had silicone particles in tissue surrounding the capsule or in lymph nodes.

“What I have learned is that old and new implants leak silicone and that starts at day 1,” said lead study author Henry Dijkman of HAN University of Applied Sciences and the Institute of Applied Biosciences and Chemistry in Nijmegen, The Netherlands.

The study also compared silicone particle migration for women who got cohesive silicone gel breast implants (n=46) and women who got either new non-cohesive gel implants or older breast implants that were not silicone (n=343). There was no statistically significant difference between the proportion of women with silicone gel bleed or migration inside or outside the capsule among those with cohesive silicone gel breast implants (95.7%) versus women with other types of implants (99.1%).

“Of course, flagyl and diflucan at the same time this group is not representative for all women, but I know that all silicone filled implants bleed, so there is a potential risk,” Dijkman said by email.

There were 47 women (12.1%) in the analysis who had silicones found only inside the capsule, the study team reports in JAMA Network Open.

Just five women (1.2%) had no silicone found in tissues inside or outside the capsule.

One limitation of the study, the authors note, is that they lacked data on the exact brands or models of breast implants used by participants. The researchers also didn’t have access to detailed clinical data for individual patients, making it impossible to link silicone particle migration to any specific patient symptoms.

The study also didn’t specify whether implants were ruptured or not at the time women presented for revision or removal procedures, said Dr. Jenny Lofgren, an assistant professor at the Karolinska Institute in Stockholm, Sweden, and coauthor of a commentary accompanying the study.

“Most likely, the risk of migration is higher in ruptured implants compared to intact implants,” Dr. Lofgren said by email. “It was not specified in the study if the implants were ruptured or not, or if there was a mix.”

The study results underscore the importance of shared decision making as women assess whether to get breast implants and weigh the risks and harms of silicone, Dr. Lofgren said.

“I think the take-home message for clinicians is that it is important to inform patients about potential risks relating to the use of breast implants and to inform that silicone can migrate to distant parts of the body,” Dr. Lofgren said.

SOURCE: https://bit.ly/2Z6veh6 and https://bit.ly/3lKMAb0 JAMA Network Open, online September 20, 2021.

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