Decreased Use of Anti-Inflammatory Medications in Autoimmune Connective Tissue Disease Patients Following Breast Implant Removal: A National Analysis

Jennifer K Shah; Daniel Najafali; Ethan Fung; Mallory Rowley; Kometh Thawanyarat; Priscila C Cevallos; Nathan Makarewicz; Karanvir S Raman; Rahim Nazerali

Decreased Use of Anti-Inflammatory Medications in Autoimmune Connective Tissue Disease Patients Following Breast Implant Removal: A National Analysis

Eplasty. 2024 Aug 15:24:e44. eCollection 2024.

Authors

Jennifer K Shah^{1

2}, Daniel Najafali³, Ethan Fung⁴, Mallory Rowley⁵, Kometh Thawanyarat⁶, Priscila C Cevallos¹, Nathan Makarewicz², Karanvir S Raman⁷, Rahim Nazerali²

Affiliations

¹ Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire.
² Stanford University School of Medicine, Stanford, California.
³ Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois.
⁴ State University of New York, Upstate Medical University, Syracuse, New York.
⁵ Internal Medicine-Pediatrics, University of Rochester Medical Center, Rochester, New York.
⁶ Medical College of Georgia at Augusta University, Augusta, Georgia.
⁷ Faculty of Medicine, University of British Columbia, Vancouver, Canada.

PMID: 39224416
PMCID: PMC11367158

Abstract

Background: Recent case studies demonstrate resolution of rheumatologic symptoms following implant explantation, raising concern around breast implant illness and associated inflammatory symptomatology. In patients with connective tissue disorders (CTD) and breast implants, we quantified the number of anti-inflammatory medications as a proxy for inflammation and disease burden before and after implant removal.

Methods: Using the Clinformatics Data Mart Database, adult female patients from 2003 to 2021 were queried. Current Procedural Terminology codes were used to identify patients who underwent implant-based reconstruction and subsequent implant removal. International Classification of Diseases, Ninth (ICD-9) and Tenth Revision (ICD-10) codes identified patients with CTD. Filled prescriptions of anti-inflammatory drugs were quantified for each patient during the preoperative, perioperative, and postoperative windows surrounding breast implant removal.

Results: Of 1015 patients meeting criteria (mean age 56 ± 12 years), 821 (81%) filled prescriptions during the preoperative window, 753 (74%) filled during the perioperative window, and 735 (73%) filled during the postoperative window. Patients filled significantly fewer postoperative prescriptions than preoperative prescriptions (P < .001).Statistically significant predictors of the number of anti-inflammatory prescriptions filled in the postoperative window included additional anti-inflammatory prescriptions filled in the preoperative (P < .001) and perioperative (P < .001) windows. Experiencing a complication was not associated with the number of prescriptions filled in the postoperative window (P = .935).

Conclusions: We found a significant decrease in filled anti-inflammatory prescriptions in patients with known CTD following implant removal, suggesting that breast implant removal may help diminish inflammatory symptomology in predisposed patients.

Keywords: Autoimmune; Connective Tissue Disease; Explantation; Medications; breast implant illness.

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