Position statement of IQUAM 15 July 2006
Accepted: 5 September 2006 / Published online: 22 November 2006
On 15 July 2006, IQUAM issued its VIIth Position
Statement, which reads as follows:
IQUAM, the International Committee for Quality As-
surance, Medical Technologies and Devices in Plastic
Surgery, is a professional medical and scientific organiza-
tion committed to the surveillance of existing and new
medical technologies, devices, and procedures in plastic
surgery and is dedicated to their safe use and to the
guarantee of patients’ safety. IQUAM reviews and eval-
uates updated literature and studies, scientific data, and
recommends standards of treatment for new devices or
technologies. IQUAM proscribes potentially deleterious use
of products, devices and technologies, or their unintended
application or application for unsuitable indications.
The purpose of breast implant surgery is to improve the
mental and physical condition of the patient. The breast
implants should be chosen depending on the needs of the
patient and their compatibility in the individual case.
Silicone gel-filled breast implants
A. Since IQUAM’s former declarations, silicone gel
continues to be widely used for breast implants. No
better alternative material is available.
B. Additional medical studies have not demonstrated any
association between silicone-gel filled breast implants
and cancer or any other disease. These studies
reconfirm prior data [1–4].
C. Silicone-gel filled breast implants do not adversely
affect pregnancy, fetal development, breast-feeding, or
the health of breast-fed children [5–7].
D. Further changes in implants structure and composition
need to be evaluated.
Titanium-coated breast implants
Implants made of titanium and titanium alloys are regarded
as inert, and they are widely used in implantology.
Nonetheless, literature reveals that metallic implants release
ions, induce a cytokine cascade that resembles a pro-
inflammatory cytokine, and subsequently, cellular reaction
 and that especially titanium and titanium alloy particles
and debris from fretting and wear are of concern. These
particles are being transported to remote sites such as
lymph nodes, liver, and spleen and even are capable of
causing splenomegaly and visceral granulomatosis [9, 10].
They seem to play a critical role in the phenomenon of
“aseptic loosening” of such implants, where polyethylene
particles arising from joint cups may add to an
unfavorable inflammatory tissue reaction [11, 12]. To
our knowledge, there are and have been breast implants
with their silicone envelopes coated with titanium. In
regard to the experiences made with hip implants of
Eur J Plast Surg (2007) 29:249–254
M. Topaz (*)
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