<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0376-7892</journal-id>
<journal-title><![CDATA[Cirugía Plástica Ibero-Latinoamericana]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. plást. iberolatinoam.]]></abbrev-journal-title>
<issn>0376-7892</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0376-78922021000200003</article-id>
<article-id pub-id-type="doi">10.4321/s0376-78922021000200003</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Enfermedad asociada a implantes mamarios: ¿cuál es la evidencia actual?]]></article-title>
<article-title xml:lang="en"><![CDATA[Breast implant illness: what is the current evidence?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[Santiago]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A1b"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lena]]></surname>
<given-names><![CDATA[Tania]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A2b"/>
</contrib>
</contrib-group>
<aff id="A1a">
<institution><![CDATA[,Hospital Pasteur Servicio de Cirugía Plástica y Microcirugía ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="A1b">
<institution><![CDATA[,Hospital de Clínicas Cátedra de Cirugía Plástica, Reparadora y Estética ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="A2a">
<institution><![CDATA[,Hospital Pasteur Servicio de Cirugía Plástica y Microcirugía ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="A2b">
<institution><![CDATA[,Hospital de Clínicas Cátedra de Cirugía Plástica, Reparadora y Estética ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<volume>47</volume>
<numero>2</numero>
<fpage>119</fpage>
<lpage>133</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0376-78922021000200003&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0376-78922021000200003&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0376-78922021000200003&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción y objetivo. Los implantes mamarios de silicona han sido objeto de duda respecto a su seguridad a largo plazo: prohibidos en 1992 por la FDA por su posible vinculación con enfermedades del tejido conectivo, autoinmunes y reumatológicas, vuelven a comercializarse en 2006. Últimamente se han asociado nuevamente a efectos adversos agrupados bajo el término "enfermedad asociada a implante" (BII por sus siglas en inglés: breast implant illness), popularizado en redes sociales. Son pacientes con prótesis mamarias de silicona que refieren síntomas sistémicos inespecíficos o enfermedades sistémicas que asocian a sus implantes. El presente trabajo pretende actualizar la evidencia científica acerca de la BII referida a su caracterización, prevalencia y tratamiento.  Material y método. Revisión narrativa a través de búsqueda secundaria en PubMed, SciELO, DOAJ y Google Scholar utilizando los términos "Breast", "Implant", "Illness" desde 2014 a 2020. Analizamos a su vez referencias secundarias, seleccionando las más significativas.  Resultados. De los 17 artículos incluidos, ninguno considera la BII como una enfermedad definida, sino un término popularizado por pacientes y personal de salud que incluye síntomas inespecíficos y enfermedades sistémicas adjudicados a las prótesis de silicona. Existe un aumento de su incidencia en las publicaciones y se ha estudiado la prevalencia de síntomas en estas pacientes, pero no hay datos de prevalencia de enfermedad diagnosticada. No hay pruebas de laboratorio para confirmar la asociación de los síntomas con los implantes; se sugiere la búsqueda de anticuerpos para enfermedades autoinmunes que puedan explicar las manifestaciones clínicas y descartar otras patologías mamarias benignas o malignas según el caso clínico. En cuanto al tratamiento, se reporta mejoría de síntomas tras retirada de implantes en 6 estudios (cohortes retrospectivos, casos aislados y estudios basados en relatos de redes sociales); la mayoría de autores recomiendan validar síntomas y en caso de voluntad de retirada de implantes por parte de la paciente, hacerlo junto a capsulectomía total y estudio anatomopatológico. Como efectos adversos tras retirar implantes se reporta infección de herida, dolor mamario, insatisfacción con resultado estético, y que los síntomas de BII no reviertan. Finalmente, se recomienda tratamiento de enfermedades autoinmunes, reumatológicas y trastornos psiquiátricos siguiendo los protocolos actuales de cada patología.  Conclusiones. El término BII se ha popularizado principalmente en redes sociales por pacientes y personal de salud como conjunto de síntomas, signos inespecíficos y enfermedades sistémicas que la paciente asocia a sus implantes mamarios de silicona. No hay evidencia científica para definirla como enfermedad reconocida. Se sugiere descartar otras enfermedades y respetar la voluntad de la paciente de retirar los implantes bajo un adecuado consentimiento informado. Se necesitan más estudios de metodología rigurosa para demostrar la asociación de los implantes de silicona con las manifestaciones descritas bajo el término BII.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background and objective. Silicone breast implants have been the subject of doubt regarding their long-term safety: banned in 1992 by the FDA for their possible association with connective tissue, autoimmune and rheumatic diseases, they were commercialized again in 2006. In recent times they have been associated again with adverse effects grouped under the term "breast implant illness" (BII), a term popularized by social networks. These are patients wearing silicone breast prostheses, who report nonspecific systemic symptoms or systemic diseases associated with their implants. The present paper tries to update the scientific evidence about BII referring to its characterization, prevalence and treatment.  Methods. Narrative review through a secondary search in PubMed, SciELO, DOAJ and Google Scholar using the terms "Breast", "Implant", "Illness" from 2014 to 2020. Secondary references were also analyzed, selecting the most significant.  Results. Of the 17 articles included, none considered BII to be a defined disease, but a term popularized by patients and health personnel which included nonspecific symptoms and systemic diseases attributed to silicone prostheses. There is an increase in the incidence in the publications and the prevalence of symptoms has been studied in patients with breast implants, but there are no data on the prevalence of diagnosed BII. There are no laboratory tests to confirm the association of symptoms with breast implants. The search for antibodies to autoimmune diseases is suggested, which can explain the clinical manifestations and rule out other benign or malignant breast pathologies depending on clinical case. Regarding treatment, improvement in symptoms after implant removal has been reported in 6 studies (retrospective cohorts, isolated cases, and studies based on social media accounts). Most of the authors recommend validating the symptoms and, in the event of the patient's desire to remove the implants, carry it out together with a total capsulectomy and pathological study. Reported adverse effects after implant removal are wound infection, breast pain, dissatisfaction with cosmetic results, and the fact that the symptoms of BII do not reverse. Finally, the treatment of autoimmune, rheumatic diseases, and psychiatric disorders is recommended, following current protocols for each pathology.  Conclusions. The term BII has been popularized mainly in social networks by patients and health personnel as the set of non-specific symptoms and signs and systemic diseases that the patient associates with her silicone implants. There is no scientific evidence to define it as a recognized disease. In the event of BII manifestations, it is suggested to rule out other diseases and respect the will of the patient for implant removal, under adequate informed consent. More rigorous methodology studies are necessary to demonstrate the association of silicone implants with the manifestations described under the term BII.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[mamarios]]></kwd>
<kwd lng="es"><![CDATA[Prótesis mamarias]]></kwd>
<kwd lng="es"><![CDATA[Gel silicona]]></kwd>
<kwd lng="es"><![CDATA[Enfermedad autoinmune]]></kwd>
<kwd lng="en"><![CDATA[implants]]></kwd>
<kwd lng="en"><![CDATA[Breast prosthesis]]></kwd>
<kwd lng="en"><![CDATA[Silicone gel]]></kwd>
<kwd lng="en"><![CDATA[Autoimmune disease]]></kwd>
</kwd-group>
</article-meta>
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