Breast implants have helped millions of women across the globe to become more confident and positively changed their lives. Although breast augmentation procedures are popular worldwide, getting implants could have some side effects.
Chances are that you have heard about breast implant illness (BII) online or on social media, and now you wonder how to recognize it or whether it could be concern.
What is breast implant illness (BII)?
Breast implant illness is not really an illness, rather a syndrome or a set of symptoms that occur in response to some patients having breast implants.
Even though the cluster of nonspecific symptoms resulting from breast enlargement with implants has become a hot topic on social media lately, the appearance of systemic illness of this kind has been present for decades.
Sometimes BII is referred to as an autoimmune/inflammatory syndrome induced by adjuvants (ASIA).
At this point, BII is not a recognized medical condition, but scientists and plastic surgeons are trying to learn as much as they can about it. A major research study funded by ASERF has already released some useful preliminary findings about BII.
What are the symptoms of BII?
Symptoms of breast implant illness are numerous and may vary from one person to another. One medical study identified 56 symptoms, but there could be over 100 of them. The most common signs and symptoms of breast implant illness include:
• Fatigue or chronic fatigue
• Arthralgia (joint pain)
• Brain fog
• Myalgia (muscle pain)
• Memory loss
• Difficulty concentrating
• Autoimmune diagnosis
• Visual disturbance/dry eyes
Breast implant illness may manifest itself in other ways, as well. Other signs and symptoms include breathing problems, sleep disturbances, dry mouth, anxiety, depression, gastrointestinal problems, and hair loss, just to name a few.
When we’re talking about symptoms of BII, it’s important to emphasize their onset may vary from one person to another, too. For example, one person may develop symptoms immediately after the implant procedure, while others can experience them weeks, months, and even years later. The exact timeline of symptoms is still unknown. Although symptoms are numerous, it doesn’t mean a single person will experience them all.
What causes breast implant illness?
The exact cause of breast implant illness is still unknown. Various factors could contribute to the development of this multifaceted syndrome. Some of these factors include:
• The inflammatory reaction of the body to a foreign object
• Response to particular approaches to the insertion of breast implants and surgical techniques
• Reaction to specific components of breast implants such as silicone gel
Heavy metal poisoning linked with tattoos or implant manufacture is also noted as a possible potential contributor to BII, but more research on this subject is necessary to confirm. Patients with tattoos are more likely to have BII.
Moreover, it’s important to mention that some women are predisposed to having an immune reaction to the materials used to manufacture breast implants. As a result, their body induces an inflammatory process that manifests itself through symptoms of breast implant illness.
How is breast implant illness treated?
Since breast implant illness is not a recognized medical condition, there is no specific treatment approach. Instead, in many cases, it’s up to every surgeon to determine what the best treatment strategy is for each patient. The process starts with diagnosing the problem. At this point, diagnosis criteria for BII don’t exist. To identify BII, it’s necessary to rule out the many other causes that induce the above-mentioned symptoms.
For many BII patients, a solution has been to remove the implants. This can be done with or without either a partial capsulectomy or an en-bloc capsulectomy, i.e. to remove both the implant and the surrounding capsule.
Every plastic surgeon may have a different approach toward addressing BII in their patients. One study found that patients who underwent explantation (including some en bloc capsulectomies) demonstrated significant improvement in BII symptoms. The improvement level was the same if done as either an en bloc or partial capsulectomy.
Many plastic surgeons do not agree with en-bloc capsulectomy approach. Despite some studies showing symptoms of BII improved after en-bloc capsulectomy, the evidence regarding its efficacy is still lacking. Sadly, en-bloc capsulectomy can even cause more problems – including puncturing the lung during the procedure.
Scientists have also found that your BMI and your implant characteristics could be related to a greater level of improvement in symptoms after explantation. That being said, a lot more research is necessary to evaluate the role of explantation in breast implant illness.
Does Bacteria or Infection contribute to BII?
A paper from the Plastic Reconstructive Surgery Global Open referred to a study where patients experienced improvement after en-bloc capsulectomy and scientists cultured various bacteria from the extracted capsule.
These findings are highly debatable because the capsule is not a microbiological barrier. Certain bacteria such as P. acnes and S. epidermidis are frequently cultured from the normal breast tissue and the skin. Moreover, each patient tends to have similar microbiomes of different tissues such as capsular, breast, and skin. This also means that different people have different microbiomes. Just like everyone’s gut, microbiota balance is different. The paper also states that some bacteria are highly unlikely to go away by this invasive surgical procedure.
As a reminder, en bloc capsulectomy is usually performed in cases when silicone implant rupture has occurred to prevent contents of the implant from leaking into other parts of the body. But in the case of breast implant illness, the physical cause of symptoms is unknown or nonexistent. In other words, proceeding with en bloc capsulectomy could mean a patient goes through an invasive treatment approach which adds greater morbidity but experiences no particular improvement in health and quality of life.
Does this mean the treatment for breast implant illness is nonexistent? No, it doesn’t. A safer and more effective approach to the treatment of BII is just removing the implant and not the capsule.
Breast implant illness is not a recognized medical condition, but it doesn’t mean the problem is fictional or imaginary. For decades the reports showed some women experienced a wide range of symptoms after undergoing breast augmentation procedures with implants. Symptoms are, indeed, numerous and their severity may vary from one woman to another. Treatment depends on the symptoms, but every surgeon may have a unique approach.
If you suspect you have BII or want to know more about it, make sure to see a specialist plastic surgeon for a professional consultation.
Further Reading and References
Dr Scott Turner FRACS (Plas) – Specialist Plastic Surgeon
Dr Scott J Turner has spent a lifetime acquiring the qualifications, education, training, and hands-on surgical experience to perform superior cosmetic plastic surgery to give you natural, beautiful results and the improved sense of well-being you want. He is one of the top Specialist Plastic Surgeons with a Breast and Body Surgery focus in New South Wales.
Achieving this personal goal requires not only in-depth knowledge of human anatomy and refined surgical techniques but an ongoing commitment to learning the latest procedures around the world. This is why Dr Turner regularly attends both local and international surgeon meetings – discussing these advances with the leaders around the world in order to offer you the most natural, effective and safest surgical procedures.
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