Evaluation of the patient with silicone gel breast implants and rheumatic complaints.

By utilizing a systematic approach to evaluate patients with implants and musculoskeletal complaints, patients can be categorized into either those with a true connective-tissue disease (scleroderma, systemic lupus erythematosus, Sjögrens) or those with nonspecific muscle and joint findings consistent with fibromyalgia. This latter subgroup represents the majority of patients who present with musculoskeletal complaints and have no evidence of a serious connective-tissue disease. Patients with silicone gel breast implants suffer great anxiety and fear over the possible association of implants and disease. Unfortunately, most of the information provided to the patient is through the media, support groups, or the legal system. Many patients are unable to evaluate this issue in an objective fashion and present to the plastic surgeon convinced that the implants are causing their problems. Consultation with a rheumatologist interested in the silicone gel implant controversy would serve to educate the patient regarding the diagnosis, as well as provide an independent source of information regarding the relationship between implants and disease. Until proper case-control studies are performed, the controversy over silicone gel implants and connective-tissue disease will persist.