Chemical and biochemical composition of late periprosthetic fluids from women after explantation of ruptured Poly Implant Prothèse (PIP) breast prostheses.

In this study we have analysed the chemical composition of the silicone extracted from two explanted intact PIP breast prostheses and of breast late periprosthetic fluid (LPF) samples from n=4 patients with ruptured PIP implants. The results obtained by ATR-FT-IR spectroscopy, GC-MS, reverse phase HPLC-UV/DAD, SEC-UV/DAD and contrast phase microscopy demonstrated for the first time that the cloudy, viscous LPF found in the breast of women carriers of PIP implants is a multiphasic amphiphilic silicone/serum microemulsion that can migrate through the body (via lymphatic system) to accumulate first in the lymph nodes. The GC-MS and ATR-FT-IR data indicate that low and high molecular weight silicones (chemical markers: D4-D9, L8) can penetrate the elastomeric shell and periprosthetic capsule and enter the breast tissue via the periprosthetic fluid. Also serum influx from breast tissue into via periprosthetic fluid through the capsule and shell into implant filler silicone (chemical markers: cholesterol by GC-MS, and uric acid, globulins and albumin by HPLC-DAD). To the best of our knowledge, the profile of the major constituents in PIP-induced LPF have been unequivocally characterised for the first time in this work. Further studies will be needed to evaluate the biological consequences of the current results. The potential toxicological implications of the results are discussed in the light of the current literature on the health effects of PIP implants.