Enfermedad relacionada con implantes mamarios de silicona o síndrome ASIA relacionado con implantes mamarios: consenso de expertos. Asociación Colombiana de Reumatología y Sociedad Colombiana de Cirugía Plástica Estética y Reconstructiva

Background and objective. Breast augmentation surgeries are very common, but in recent years there has been a growing interest in their possible relationship with the appearance of nonspecific symptoms and signs, as well as the development of autoimmune disorders. The lack of a unified consensus about the syndrome poses a controversial issue for the scientific community and generates uncertainty among women with breast implants in Colombia. The aim of this paper is to provide guidance on the evaluation, approach and follow-up of the silicone breast implant-related disease or ASIA syndrome, based on evidence and the opinion of clinical experts. Methods. A group of experts from the Colombian Association of Rheumatology and the Colombian Society of Plastic, Aesthetic and Reconstructive Surgery was formed. An independent methodological team carried out a systematic review of the literature from which a consensus process was developed using the modified Delphi method. Results. The available evidence on the association between silicone breast implants and the development of symptoms, autoimmune disorders, or rheumatic diseases is limited and a definitive causal relationship has not been demonstrated. The certainty in the current evidence on the topic is low due to biases and heterogeneity of the studies and nonspecific and self-reported symptoms. On this basis, 22 consensus statements were formulated, highlighting the importance of an individualized medical approach, comprehensive evaluation, and effective communication with patients about risks and expectations before implantation and explantation procedures. Conclusions. The evaluation and therapeutic decisions in women with suspected silicone breast implant-related disease should be based on the available scientific knowledge. Future research should explore the causality of the syndrome and improve the characterization of the disease.