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IMCAS World Congress 2025
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BIA diseases: Myth or reality

Room: Room 242 - Level 2
Date: Thursday 30 January 2025 at 16:00 to 17:00
Format: FOCUS SESSION > lectures covering a major topic of the congress

Chairs

Dr Nathalie BRICOUT

Plastic Surgeon

France

Dr Sebastien GARSON

Plastic Surgeon

France

Dr Bouraoui KOTTI

Plastic Surgeon

United Arab Emirates

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
16:00	Dr Melinda HAWS	Current status of BIA-ALCL, BIA-SCC, and BII in the US	View	140147
16:14	Dr Cole HOLAN	Analyzing sentiment of breast implant illness on social media with natural language processing and deep learning	View	144164
16:28	Dr Isabelle PLUVY	Breast implant silicone exposure induces immunogenic response and autoimmune markers in human periprosthetic tissue	View	145145
16:42		Discussion and Q&A		140153

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Dr Melinda HAWS

Plastic Surgeon

United States

Other author(s) : Includes review of papers published by Caroline Glicksman MD and Pat McGuire MD

Current status of BIA-ALCL, BIA-SCC, and BII in the US

Objectives: To update the audience on latest research in BII as well as current FDA counts of SCC and ALCL with breast implants and how this is incorporated into a breast implant consult so that the patient is well educated and can make informed decisions

Introduction: The FDA is still tracking cases of BIA SCC and BIA ALCL world wide. Incidence and mortality data will be reviewed. In addition, review of 5 papers funded by ASERF published in ASJ regarding systemic symptoms with breast implants will be reviewed

Materials / method: Review of FDA website data and its implications. Review of the four papers on SSBI (BII) in the 150 patient initial study as well as the 100 patients in the follow up no capsulectomy study will be reviewed.

Results: The FDA still Indicates a low incidence of BIA SCC, and never found in a normal capsule. The FDA indicates there are still deaths occurring from BIA ALCL despite evidence to show a very curable disease if discovered early.

The SSBI (BII) papers found no cause for symptoms in the SSBI group as compared to the 2 control groups. Pathology, heavy metals, and microbiology were all performed on the capsules. Serum levels of various cytokines, endotoxins or other abnormalities were not found. In the BII cohort there was a significant drop off of symptoms after implant removal

Conclusion: Practioners should still watch and testfor BIA ALCL and SCC. Patients complaining of SSBI (BII) have statistically symptom improvement after implant removal despite negative causative findings regardless of whether capsule is removed or not. The only symptom that never approaches baseline is anxiety. True incidence of BIA SCC and BIA ALCL and their warning signs as well as occurrence of SSBI(BII) should be discussed with preop breast implant patients. Higher anxiety levels in those SSBI patients should be discussed, particularly in patients with preexisting anxiety.

Disclosures

Did you receive any funding to support your research for this TOPIC?
Yes
Please specify entities (individual, company, society): ASERF. The Aesthetic Foundation

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work is presented thanks to the support of: ASERF

Dr Cole HOLAN

Plastic Surgeon

United States

Other author(s) : Arman Fijany, MD, Jorys Martinez, MD

Analyzing sentiment of breast implant illness on social media with natural language processing and deep learning

Objectives: The study aims to analyze social media posts to understand patient perceptions and emotions regarding BII and to assess the relationship between the sentiment of these posts and breast implant removal rates.

Introduction: Breast Implant Illness (BII) is identified by patients as a range of symptoms related to breast implants, with increasing public interest despite no conclusive research on causality. Social media has become a key platform for sharing patient experiences and perceptions of BII. The RoBERTa NLP model, trained on extensive social media data, offers insights into these discussions.

Materials / method: Posts mentioning BII from January 2014 to December 2023 on platform X were collected and analyzed using two NLP models: a binary sentiment model and an emotion-based model. The models categorized posts as positive or negative and identified dominant emotions. Correlations between post sentiments, emotions, and implant removal data were examined using the Pearson correlation coefficient.

Results: Out of 6,099 posts over ten years, the majority were negative (75.4%), with neutrality (35.9%) and fear (35.6%) being the most common emotions. Excluding neutral posts, fear dominated 55.5% of the discourse. A strong positive correlation (r > 0.80) was found between negative, neutral, and fear posts and the rates of implant removal.

Conclusion: The analysis reveals that discussions on BII are mainly negative, with a significant focus on fear, which correlates with the increase in breast implant removals. This highlights the role of NLP in understanding patient sentiments and aiding healthcare providers in addressing patient concerns.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Isabelle PLUVY

Plastic Surgeon

France

Other author(s) : I Brigaud, E Randrianaridera, M Melin, F Gindraux, K Anselme

Breast implant silicone exposure induces immunogenic response and autoimmune markers in human periprosthetic tissue

Objectives: We present a pilot study investigating the inflammatory characteristics of human periprosthetic tissue following silicone exposure. In particular, we focus on changes in (i) tissue organization and (ii) transcriptomic signatures of human periprosthetic tissues exposed to different sources of silicone with respect to implant integrity (intact or ruptured), surface texturing (macro- or microtexturing) and implant filling (silicone gel or serum). This work provides new insights into the immunological mechanisms triggered by silicone, and, once again, challenges the concept of silicone safety.

Introduction: Silicone-based breast implants are commonly used, but there are concerns about theirlong-term safety. While implantation results in the formation of a periprosthetic tissue that isolates the implant from the rest of the host body, silicone can leak and reach surrounding tissues.

Materials / method: We combined histological analysis and gene expression profiling (RNA sequencing) of samples from human patients with silicone breast implants with different fillers (silicone or serum), surface topographies and/or shell rupture, and performed systematic cross-comparisons.

Results: Our study shows that exposure to silicone gel filler, even in clinically asymptomatic cases, induces an immune response. This response includes the expression of markers associated with various autoimmune diseases. We found an upregulation in the expression of genes encoding metalloproteinases (mmp1 and mmp9), onco-inflammatory markers (tnfsf13) and other genes associated with chronic inflammation such as il18, nlrc4, blnk or pycard and tnsfs14, both previously identified as diagnostic markers for rheumatoid arthritis.

Conclusion: This study provides the first biological evidence of an association between
silicone implants and autoimmune markers, highlighting the need for further research and stricter implant safety regulations. We suggest that implant design factors, such as filler type and surface texture, may influence the inflammatory response. Re-evaluation of existing clinical trials is warranted to investigate the association between implant characteristics and potential health risks.

Disclosures

Did you receive any funding to support your research for this TOPIC?
Yes
Please specify entities (individual, company, society): Agence Nationale de la Recherche ANR “Safe-implant” (ANR-22-CE19-0028-01)

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work is presented thanks to the support of: Agence Nationale de la Recherche ANR “Safe-implant” (ANR-22-CE19-0028-01)

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IMCAS World Congress 2025 Program

BIA diseases: Myth or reality

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IMCAS World Congress 2025
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