Breast implant illness is real, vague, and frustrating. This was a study of “Qualitative Study on the Experiences of Women 
with Breast Implant Illness” in the April 2022 Aesthetic Surgery Journal. In this study they wanted to look at women’s experiences of BII- symptoms, how is it to navigate the healthcare system, social media, and breast implant removal surgery.
The study was small- 29 women who self-identified as having BII. Interviews were done and recorded and then the data was analyzed. Mean age was 43.
There were 6 themes:
- Symptoms without explanation. There was a gradual progressive noticing of symptoms, which was unpredictable. For most, the severity worsened over time. “Left without answers.” “Loss my old self” There was a sense of loss of not being the same happy active person anymore.
- Invalidation/invisibility. Healthcare people dismissed their symptoms as being caused by allergies, hysteria, or anxiety. Not all healthcare workers dismissed them, frequently feeling heard by their explant surgeon. They felt invisible, because they were not feeling ok, but they put on a facade to hide it during their daily lives.
- Making the BII connection to their issues. They did not relate it to the implants at first, but gradually transition over time. This was often from finding support and validation on social media.
- Implant toxicity. This has to do with the belief the implants are releasing toxins and heavy metals into their body, causing an immune response.
- Explant surgery- is it a solution to end the suffering? Nothing else has worked. They spent time and money trying other treatments, mediations, diets, supplements. Many who did explant surgery felt better after the surgery, though not all did, and for those who did not improve they felt defeated.
- Concealed information. They felt they were uninformed of the risks before undergoing surgery, and some felt the FDA or implant manufacturers were hiding the lack of breast implant safety or had insufficient research into the safety.
When doing this paper, they found women who were really distressed, which affected their relationships, work, identity, physical health, and mental health.
They attributed the symptoms to implant toxicity and their immune system rejecting the foreign objects.
When healthcare did not validate their concerns, they turned to social media for support and information, and they saw explant surgery as their only chance of recovery.
In their discussion, they bring up some good points:
- Studies are few on BII explant surgery and have conflicting results.
- Social media groups make women feel supported and validated, but several experts believe it may worsen anxiety through the spread of misinformation.
- Regardless, healthcare needs to understand the BII toll- psychological and physical- to help women have less distress, disability, and help guide them to treatments.
My thoughts?
As a female plastic surgeon who does a lot of breast surgery, I do a lot of explants. I often see women who have health issues and have tried everything- diets, allergy testing, etc- and they come to me as a “last resort” to see if the implants are the issue. These women are in true distress, and it has frequently rippled into other aspects of their lives- how active they are, their relationships, their ability to exercise, their work.
I do believe implants can make someone feel bad, particularly if they have biofilm, chronic inflammation, capsular contracture, or ASIA syndrome. You can read my numerous blogs on all those subjects.
Some basic observations from my practice of over 20 years:
- Not all breast augmentation patients have BII. Just looking at the sheer numbers, many women have implants and have no health issues.
- Implant placement is important. Antibiotic soaks, presurgery preps, Keller funnels, incision sites, submuscular- all of these may help mitigate risk.
- When explant is done, sometimes the symptoms go away, sometimes they do not.
- I think biofilm and chronic inflammation may be the root issue
- If you want your implants out- whether they are the cause of the health issues or not- there is a benefit to removing them, if nothing else for your peace of mind.
I think this is an important issue. The FDA has mandated Breast Implant Illness is discussed for patients receiving implants. Read the FDA’s September 2020 recommendations for breast implant labeling to improve patient communication. Being informed of risks is important. This is an individual choice, and you need to understand it fully.