Are silicone breast implants actually safe?

An enormous amount of time and money has been spent attempting to figure out if silicone breast implants are truly safe, but according to a new review out of Brown, there is no definitive evidence to show that these implants are actually harmless.

This is, of course, following a somewhat contentious history. In the U.S., silicone gel breast implants were suspended from use for 14 years, only to be allowed back on the market in 2006. Despite the studies that resulted because of the suspension, proof that these implants are or are not linked to health problems—like cancer and connective tissue disorders—has remained evasive.

And so, a team of scientists led by Dr. Ethan Balk, assistant professor of health services, policy, and practice at Brown University, reviewed 32 studies that compared the health of women who received or did not receive these implants.

Health effects up in the air

What they discovered: None of the 32 studies had enough statistical rigor to be conclusive about the potential health effects of silicone gel breast implants.

“Despite numerous studies reporting on the risk for many diseases and conditions, evidence was insufficient of an association between breast implants and any health outcome,” wrote the team in Annals of Internal Medicine. “No outcome had at least two adequately adjusted studies that yielded consistent estimates of associations. … There was a general lack of adequate accounting for possible confounders.”

One of the main difficulties, Balk explained, is that there are fundamental differences between women who get breast implants (for augmentation, restoration after a mastectomy, or otherwise) and women who don’t—making a direct comparison of the two difficult.

“Some of these differences are easily measurable,” explained Balk in a statement. “For example, they [who augment] are more likely to smoke, be thin, and white. But many are difficult to measure quantitatively. For example, they are more likely to have been teased about their appearance.”

These differences can be accounted for, if studies make sure to ask for such information—but many did not, meaning trends in their data (like incidence of cancer) could be a result of, say, smoking. Balk suggested that some studies would benefit from re-analyzing to introduce more confounders (things like smoking that can cause a false positive), or from new methods of research.

“We are hopeful that this study will serve as a guide to future researchers to improve analyses of currently available studies and of future studies,” he said.

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