Perceptions of Silicone Structure and Function
- PDF / 165,913 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 96 Downloads / 177 Views
LETTER TO THE EDITOR
Perceptions of Silicone Structure and Function Nevio Cimolai1,2
Received: 20 March 2020 / Accepted: 23 March 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Dear Editor, Two recent papers in the journal aptly raise concerns in regard to future research that is required to better understand the concepts of silicone implant incompatibility or toxicity [1, 2]. The latter comprehensive reviews set the stage for much in the way of future hypothesis testing. As is well known to this time, there are several forms of adverse reaction to implants that contain silicone. Some of the latter are purely and obviously allergic reactions [3–6]. Others are more complex in the form of potential and variable autoimmune and similar presentations as the recent papers in this journal discuss. Despite the association of some silicone-based implants with large cell anaplastic lymphoma, there continues to be considerable skepticism about the entities of incompatibility or toxicity, and it is evident that much debate will continue until the science is furthered [7]. One of the most important starting points in any such progression, however, is recognition that the general term ‘silicone’ means different things to different people and understandably so. ‘Silicone’ has been generically used both in lay circles and considerably in the medical field with the guise of & Nevio Cimolai [email protected] 1
Faculty of Medicine, The University of British Columbia, Vancouver, Canada
2
Children’s and Women’s Health Centre of British Columbia, 4480 Oak Street, Vancouver, BC V6H3V4, Canada
implying a homogeneous or chemically defined entity, but the complexities of such compounds have been well known. Also termed siloxanes due to the polymer backbone of silicon–oxygen, these compounds can vary greatly in lengths and cross-linkages [4, 8]. Variations in such structure allow for the composite to exist in the form of fluid, gel, microparticle, or larger solids. Medical products can therefore vary in their format of siloxane polymer and may indeed be a composite of more than one silicone. Some medical products may have coatings with other compounds [9]. The production of silicones also can vary with the use of varying chemicals for process catalysis or filling. The texture of the final product also commands consideration [7]. It is evident therefore that silicones can be heterogeneous and that such heterogeneity has the potential to complicate our appreciation of how they may or may not cause incompatibility and/or toxicity. As has been well consolidated in immunology and biochemistry, receptor ligands vary in their affinity for various structures. Such affinity can differentiate very simi
Data Loading...
