From silicone gel bleed chemistry to skeletal muscle and lipid alterations: clinical and in vitro evidence

Silicone breast implants have been linked to musculoskeletal symptoms, yet the exact biological mechanisms remain unclear due to the ongoing debate over silicone's biocompatibility. Researchers have now chemically analyzed the low-molecular-weight fraction of the silicone exposome, released through implant gel bleed, and studied its potential effects on skeletal muscle using a combination of analytical chemistry, clinical transcriptomics, histology, and in vitro muscle experiments.

Analyzing periprosthetic tissues from silicone implant ruptures, the researchers discovered unexpected myogenic and neuromuscular signs in tissues typically considered mostly fibrous. These findings were further supported by histological evidence of close interactions between periprosthetic tissue and skeletal muscle. By examining the implant-gel extract, the team identified linear siloxane L2 and cyclic siloxanes D3-D8, with possible D9 assignment.

In vitro experiments using C2C12 cells exposed to the implant-gel extract revealed up to a 30% decrease in viability and reduced expression of critical neuromyogenic genes.

Collectively, these findings suggest that low-molecular-weight constituents of the breast implant silicone exposome may have a biologically active effect on skeletal muscle. The associated changes in lipid metabolism and transport provide a potential mechanism for understanding how hydrophobic silicone-derived species are handled and distributed within tissues. The study positions silicone gel bleed as a biologically relevant source of chemical exposure, rather than merely a material-integrity issue.