Silicone Breast Implants and Heart Health: A Silent Threat?

What Is the Price of Beauty?

Used for cosmetic and reconstructive purposes since the 1960s, silicone breast implants have affected the lives of millions of women worldwide. However, scientific findings increasingly suggest that these implants may carry vital health risks beyond cosmetic concerns. In particular, they are thought to adversely affect the diagnostic process for cardiovascular disease.

Why Are Women at a Greater Disadvantage in Cardiac Testing?

Coronary artery disease (CAD) has a worse course in women than in men. Classic symptoms such as typical chest pain are less common in women, and diagnostic tests are less sensitive. More sophisticated and sensitive imaging methods are therefore used to detect disease in women.

However, the reliability of these tests is substantially reduced in women with breast implants commonly referred to as silicone implants. This can lead to false-positive results and unnecessary invasive procedures.

How Do Breast Implants Interfere With Cardiac Imaging?

• SPECT (Single-Photon Emission Computed Tomography) and PET are myocardial perfusion imaging methods in which silicone- or saline-filled breast implants block the passage of X-rays, causing attenuation artifacts in the images.

• During stress echocardiography, silicone implants make it harder for ultrasound waves to reach the heart, causing acoustic shadowing.

This increases false-positive rates, particularly in women whose need for cardiac testing rises with age.

Key Findings From the Newly Published Study

In April 2025, The American Journal of Medicine published a large retrospective data analysis showing differences in abnormal cardiac function tests, angiography rates and invasive intervention (PCI) rates in women with breast implants:

• Women with breast implants were 10 years younger , yet more often had abnormal cardiac function tests (age 55.06 vs 65.06; P < 0.001).

• Abnormal cardiac test results remained significantly more frequent even after adjustment for age, ethnicity, diabetes, hypertension, hyperlipidemia, myocardial infarction, chronic kidney disease, breast cancer and smoking (OR: 1.78; 95% CI: 1.22-2.68; P = 0.02).

• Coronary angiography was more frequent in this group (OR: 1.3; P < 0.001), but invasive treatment (PCI, placement of a stent in a coronary artery) was less frequent (35.7% vs 46.2%; adjusted OR: 0.79; P = 0.01).

What Does This Mean?

In women with breast implants:

• More abnormal cardiac test results,

• More unnecessary angiograms without actual arterial blockage,

• But ultimately fewer PCI procedures,

lead to the following conclusion: Breast implants reduce the diagnostic accuracy of noninvasive cardiac tests and create unnecessary costs and risks within the health system.

Proposed Solutions: Which Test for Which Patient?

• Instead of SPECT, PET-MPI may be preferred because attenuation correction is more reliable in PET imaging.

• Advanced CT angiography (CTA) methods may be an alternative, particularly in younger patients with normal kidney function.

• Attenuation correction can be provided by modern SPECT devices equipped with this capability.

• In some cases, methods without imaging, such as exercise ECG (treadmill testing), may be preferred to reduce false positives.

Patient Information Is Essential!

Women considering breast implants should be clearly informed that these devices may affect not only their physical health but also diagnostic testing. Avoiding unnecessary coronary angiography is important for both patient safety and health-system efficiency.

Conclusion: Do Not Let the Heart Pay the Price of Beauty

This study demonstrates for the first time, using a large patient dataset, that breast implants may present an important obstacle to diagnosing heart disease. Procedures performed for cosmetic reasons can complicate serious health-care processes later on. A holistic approach to women's health now requires cosmetic and functional risks to be assessed together.