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 can have some side effects like BII – Breast Implant Illness.
Just like any surgical intervention, breast augmentation is associated with certain risks and complications such as swelling, bruising, delayed wound healing, and infection. However, when it comes to this type of procedure – where breast implants are used – there is a different, specific set of complications that could occur. These are rare complications, but patients must be informed and aware. Breast Implant Illness (BII) is one of these complications.
If you had breast implant surgery, you might want to know what BII is and whether it is a reason for concern. Let’s see what are the details, symptoms and possible treatment plans.
What Is Breast Implant Illness (BII)?
Breast implant illness is not an illness per se. It is rather a syndrome or a set of symptoms that occur in some patients in response to having breast implants. Sometimes, BII is referred to as an autoimmune/inflammatory syndrome induced by adjuvants (ASIA).
At this point, BII is not a recognised 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 on BII.
Breast Implant Illness Symptoms
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
- Joint pain
- New food allergies or intolerance
- Slower hair growth
- Reproductive problems
- Low immunity
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 emphasise that 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.
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.
Patients experiencing BII might actually already have a known breast implant complication. Capsular contraction– scar tissue formed around the implant- rupture, wrinkling, infection or a seroma are all potential complications that could occur after breast implant surgery. When these complications are treated appropriately, they typically resolve.
Treatment Options for Breast Implant Illness
Since breast implant illness is not a recognised medical condition, there is no specific treatment approach. Instead, in many cases, it’s up to the surgeon to determine what the best treatment strategy is for each patient. The process starts with diagnosing the problem. At this point, there is no clear diagnosis for BII. 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.
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.
Despite some studies showing symptoms of BII improved after en-bloc capsulectomy, the evidence regarding its efficacy is still lacking.
Researchers have also found that your BMI and your implant characteristics could be related to an improvement in symptoms after explantation. That being said, a lot more research is necessary to evaluate the role of explantation for 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. A safer and more effective approach to the treatment of BII is just removing the implant and not the capsule.
Silicone implants have been used for more than sixty years. And there still isn’t evidence that indicates a link between breast implants and your risk of developing health conditions such as BII. Preventing and/ or treating possible side effects of cosmetic surgery is one of the reasons it’s so important to go to a specialist plastic surgeon.
Your surgeon should provide follow-up support after your surgery and discuss any concerns that develop throughout the lifetime of your implants.
Breast implant illness is not a recognised 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.
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
- PMC US National Library of Medicine – Breast Implant Illness: A Biofilm Hypothesis
- PMC US National Library of Medicine – Understanding Breast Implant Illness, Before and After Explantation
- PMC US National Library of Medicine – Breast Implant Illness, Biofilm, and the Role of Capsulectomy
About 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. He is a committed board member of ASAPS – Australia Society of Aesthetic Plastic Surgeons
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