Early Systemic Immune Response to Silicone Breast Implants Analyzed by Flow Cytometry

Background Silicone breast implants are used in a variety of aesthetic and reconstructive procedures such as permanent implants or tissue expanders. As foreign biomaterials, they can potentially evocate either a local inflammatory reaction or a systemic immune response. This study aimed to quantify possible alterations in white blood cells and lymphocyte subpopulations in patients who underwent silicone implant-based breast augmentation through peripheral blood analysis with flow cytometry at three and 12 months postoperatively. The same patients acted as the control group with a preoperative peripheral blood collection. Methodology This retrospective study included 14 female patients (average age = 29 years; range = 18-44 years) who underwent breast augmentation with silicone implants. Flow cytometry was used to monitor their immunologic reactions. Peripheral blood samples were obtained before, three months, and 12 months after the operation. Flow cytometric analysis was performed to assess the distribution of total leukocytes and the expression of specific lymphocyte subsets using the following antibody panel: anti-CD3, anti-CD4, anti-CD8, anti-CD16/CD56, anti-CD19, and anti-CD25. Results The immunophenotypic analysis showed that the vast majority of the peripheral blood lymphocytes consisted of T lymphocytes (CD3+), followed by natural killer (NK) cells (CD3-/CD16+/CD56+, NK cells), and B lymphocytes (CD3-/CD19+) in all periods of the study. The peripheral blood CD3+ T-lymphocyte subsets were predominantly T-helper lymphocytes (CD3+/CD4+), followed by cytotoxic T lymphocytes (CTLs) (CD3+/CD8+, CTLs), and a small percentage were T-regulatory (Treg) cells (CD4+/CD25high, Treghigh cells). Interestingly, lymphocytes showed a slight increase and T-helper lymphocytes a slight decline postoperatively, with no evidence of statistically significant shifts. Overall, there was no statistically significant difference in the temporal distribution of the peripheral blood lymphocyte subpopulations. Conclusions To our knowledge, the novelty of our study is that the same patients who underwent breast augmentation with silicone implants were used as the control group. There was no evidence of an early specific systemic immune activation in these patients. Hence, flow cytometry could be a reliable method that can be used as an in vitro test to evaluate the biocompatibility of silicone implants and observe patients with immune activity for possible clinical manifestations of symptoms in the future.