Breast Implant Illness after Breast Augmentation

What is Breast Implant Illness?

Breast Implant Illness (BII) is a group of symptoms in women who have undergone breast augmentation. These women feel the symptoms are related to the toxic effects of breast implants.

Symptoms of Breast Implant Illness?

The symptoms that have been described with Breast Implant Illness include:

• Acute or chronic fatigue or tiredness
• Brain fog
• Inability to concentrate
• Memory loss
• Muscle aches, pains or weakness
• Joint pain or soreness
• Hair loss
• Dry skin, eyes or mouth
• Weight gain or loss
• Easy bruising
• Slow-healing cuts and wounds
• Temperature intolerance
• Low libido
• Ringing in the ears
• Heart palpitations
• Shortness of breath
• Night sweats
• Skin rashes
• Metallic taste in the mouth
• Inability to sleep
• Swollen, tender lymph nodes
• Tingling or numbness in the hands, arms, legs or feet
• Cold intolerance
• Foul body odor
• Dizziness
• Fevers
• Visual changes
• Sensitivity to the sun
• Infections
• Nails cracking or splitting
• Anxiety or panic attacks
• Stomach pain
• Increased allergies
• Headaches or migraines
• Depression

Causes of Breast Implant Illness?

The specific cause of Breast Implant Illness has not been determined. However, several theories have been postulated:

• An increased inflammatory reaction to a foreign object i.e silicone breast implant or implant shell
• A specific reaction to a specific component of the breast implant
• A response to a subacute infection or Biofilm which forms around the implant

What is the history of breast implant use and body symptoms?

An article in the journal Plastic and Reconstructive Surgery summarizes the history of breast implants and systemic disease, critically analyzes the literature (and any associated deficiencies), and suggests a way forward through systematic scientific study.

Diagnosis of BII and Tests on Implant

Unfortunately, there are no lab tests or radiographic studies that will specifically diagnose BII. Breast Implant Illness is considered a diagnosis of exclusion; meaning all other possible causes of the symptoms are excluded before considering this diagnosis.

• Tests that may be done include:
• Cell Blood Count
• Complete Metabolic Count
• Ultrasound
• MRI
• Biopsy if a mass or enlarged lymph nodes are present
• Consultation with a rheumatologist

Tests on Implant and capsule

The implants and capsules will be photographed and sent to pathology for macroscopic and microscopic evaluation. The tissue may be cultured for infection. Tests for BIA-ALCL, such as CD30IHC, will be conducted if indicated. Unfortunately, there are no specific tests that can be performed on the implants or capsules to identify the cause of breast implant illness.

En Bloc Breast Implant Removal as Treatment

What is En Bloc breast implant removal?

En Bloc breast implant removal means the implant and scar tissue around the implant, i.e. the capsule, are removed “en bloc” or as one piece. This means the capsule is dissected from the surrounding breast tissue with the implant inside. The capsule is never opened to prevent any of its contents to be exposed to the body. Thus, this removes the capsule, the implant and any toxins which have been leaked by the implant from the body.

After the procedure

Drains may or may not be needed depending on the extent of the surgery and the size of the cavity after the en bloc breast implant removal has been performed. The incision for the en bloc removal is usually significantly longer than the original implant surgery and is located in the inframammary crease.

 

Is everybody a candidate for an en bloc breast implant removal?

Despite what several surgeons have stated, not every patient is a good candidate for the procedure. En bloc removal may not be possible if:

  

The capsule is thin and delicate to remove:

The capsule is too thin and delicate to remove in one piece. In this case, as much of the capsule will be removed with the implant.

Breast tissue or skin is very thin:

The breast tissue or skin overlying the capsule is very thin. For patients with very thin skin, removing the capsule could risk thinning of the skin and result in tissue necrosis (tissue death) from lack of blood supply. If this is under the nipple, the nipple will die and the patient is significantly disfigured. Thus, leaving the capsule intact is a much safer option.

The capsule is adhering to vital tissues:

The capsule is adhering to vital tissues. For example, if scar tissue is tightly attached to the rib cage, removing the tissue could risk injuring the chest wall or rarely the lungs.

What will my breasts look like after the En Bloc Breast Implant removal?

The breasts will lose their volume based on the size of the original breast implant. If there is not a lot of breast tissue left, the skin may ripple, pucker, sag or become adherent to the chest because of the loss of the volume.

Replacing Volume Lost by Removing the Breast Implants

A breast lift may help lift the breast and nipple giving it a better shape. This may be combined with fat grafting to add additional volume.

Breast Fat Grafting

Fat grafting involves using liposuction to harvest fat from the tummy or thighs. The fat is then cleansed and separated from the body fluids. The pure fat is then injected into the breast to add volume. Fat grafting can be performed with or without a breast lift.

Recognize that there must be enough fat elsewhere on the body to be harvested for the procedure. Also, there must be a location in the breast, not where the capsule or implant was, that has enough tissue for the fat to be injected into. This allows the fat to obtain a blood supply so it may survive and not cause fat necrosis.

FDA’s position on Breast Implants

The FDA considers all currently available breast implants safe to use. However, they have never considered lifetime devices. Here is a link to the FDA’s Risks and Complications of Breast Implants:

FDA: Breast Implants – Risks and Complications

What is the FDA doing about this?

On May 2, 2019, the FDA Principal Deputy Commissioner, Amy Abernathy, issued the following statement detailing the plan to investigate Breast Implant Associated-Anaplastic Large Cell Lymphoma BIA-ALCL and Breast Implant Illness BII:

FDA Statement on BIA-ALCL and Breast Implant Illness

Frequently Asked Questions

What is the research supporting the link between breast implants and Breast Implant Illness?

Recent published systematic reviews investigating BII and breast implant safety have shed some light on the matter.