The American Board of Cosmetic Surgery Answers Your Questions About Breast Implant IllnessJune 12, 2019 | ABCS
At the American Board of Cosmetic Surgery, we stay abreast of developments related to cosmetic surgery and medical devices used in aesthetic medicine—an important part of which is understanding surgical risks related to cosmetic procedures.
We’ve already discussed BIA-ALCL, the risks involved, and our recommendations if you suspect something is wrong with your breast implants. But there’s another condition currently gaining notoriety: breast implant illness.
What is breast implant illness?
Breast implant illness (BII) is a general term used to describe a broad range of physical symptoms some women with breast implants are experiencing. While the term breast implant illness is currently not an official medical diagnosis, it has become synonymous with certain inflammatory symptoms that may or may not be the result of, or exacerbated by, having breast implants.
When we say breast implant illness is not an official medical diagnosis, it is not to minimize the very real pain these women are experiencing—but rather to clarify the fact that the medical community is still working to understand this emerging condition. We do not yet have enough data to identify a clear connection between breast implants and reported symptoms, but some women with systemic health issues report a resolution of symptoms by having their breast implants removed.
There is currently no way to diagnose breast implant illness. We can only rule out other inflammatory conditions with similar symptoms, such as Lyme disease or MS, and remove the implants to see if this relieves symptoms for the patient.
What are the symptoms of breast implant illness?
While there is no standard set of symptoms that are experienced by all women who believe their breast implants are at the root of systemic issues, BII patients typically report at least a few of the following:
- Chest pain
- Chronic pain
- Hair loss
- Brain fog
- Difficulty sleeping
- Hormone fluctuations
Because the spectrum of symptoms is fairly broad—and they can overlap with a number of other conditions—it’s important to be aware of changes in your physical health and note what you experience to assist with your diagnosis and treatment.
While it cannot be certain until after implant removal if a patient’s symptoms are indeed connected with her implants, a number of illnesses with similar symptoms can be ruled out or diagnosed with lab tests. Your regular physician can order these tests or may refer you to a specialist. Eliminating other possible causes will help you understand the best course of treatment and if you should consider having implant removal surgery.
Can you test for breast implant illness?
Unfortunately, there is currently no diagnostic test specific to BII. That means doctors must use a process of elimination to see if BII is a possibility.
Diagnostic testing for autoimmune diseases is the first step. Ruling these out could save you time, money, and unnecessary trauma to your body if you don’t need implant removal surgery to experience relief. In some cases, patients receive a positive diagnosis for another condition and begin necessary treatment.
Patients who do not test positive for other diseases may wish to have their breast implants removed as a “test” treatment to see if taking this step will provide relief. Some women feel that even if implant removal does not relieve their symptoms, it can increase peace of mind and eliminate one source of concern.
Is there data showing causation between breast implants and these symptoms?
A 1999 review performed by the Institute of Medicine Committee on the Safety of Silicone concluded there was no demonstrated link between silicone breast implants and any systemic illness. Numerous studies over the years have looked at the safety of breast implants and any relation to autoimmune disorders and diseases, and few-to-no links have been found between breast implants and any disease.
Studies of patients who have reported these symptoms have also not shown any consistent laboratory abnormalities that could define a distinct syndrome. Because of this, research on breast implant illness has been limited.
However, this does not definitively mean a link does or does not exist. One criticism of past breast implant studies is that they have been discontinued too early; patients reporting breast implant illness symptoms have often had their implants for many years before symptoms started to show. The medical community is working to adjust current studies to account for questions about past studies.
Will removal of breast implants improve breast implant illness symptoms?
Currently, because there is no definitive epidemiological evidence supporting a direct link between breast implants and any specific disease, no doctor will guarantee that breast implant removal will help a patient. That being said, it can take years to come to a scientific conclusion with rare or unusual diseases, and patients need not wait for definitive evidence if they have ruled out other conditions and are willing to undergo implant removal surgery.
Varying degrees of improvement with certain symptoms have occurred in some patients after removal of their breast implants. Some even experience a permanent resolution of specific issues. Other times, symptoms continue to persist after the breast implants have been removed.
What do I do if I suspect I have breast implant illness?
If you have any health concern, your first step should be scheduling an appointment with your primary care provider. We recommend keeping an open mind, focusing on your symptoms rather than your implants, and going through a full diagnostic process.
If your doctor or specialist is unable to determine what may be causing your symptoms and believes that breast implant removal may be the next step, contact your original surgeon or a board certified cosmetic surgeon in your area who is experienced in breast implant removal.
Provided it is safe to do so, you and your cosmetic surgeon can make the decision to remove your breast implants to see if your symptoms improve. If there is no improvement after your removal, we recommend seeking further treatment from a physician who specializes in autoimmune or inflammatory diseases.
Don’t hesitate to request a check-up
If you have any questions or concerns about your breast implants, we encourage you to speak with a board certified cosmetic surgeon. Even if you do not have breast implant illness symptoms, anything that feels different about your implants should be examined so complications can be ruled out or addressed as needed. If you have silicone breast implants, the FDA recommends regular MRI screening to detect silent ruptures—three years after your initial procedure and then every two years following.
Breast implants are not lifetime devices, and routine examination can help you catch any issues early on. After 10 years, the risk of developing complications such as capsular contracture or implant rupture increases, so checking back in with your cosmetic surgeon is recommended.
We hope this article has helped you understand more about breast implant illness and breast health.