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Do you have breast implant illness? - MSR News Online

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If you’re not quite sure what breast implant illness (BII) is, don’t be alarmed: It is a relatively new term for a condition that isn’t completely understood. Breast implant illness is a term coined by some women and doctors to refer to a wide range of symptoms that can develop after undergoing a surgery with breast implants. 

For example, it could happen after a breast reconstruction or after a cosmetic breast augmentation surgery. BII can occur with any type of breast implant, whether silicone or saline-filled; smooth surface or textured surface; and also with round or teardrop-shaped implants. 

BII symptoms

People afflicted with BII may be impacted in different ways. Also, the symptoms can appear any time after surgery with breast implants. For example, some people develop symptoms almost immediately after surgery, while others develop symptoms years later. 

While there’s no doubt that these symptoms are real, researchers are still trying to determine if they are caused by implants or if they’re related to a separate illness or condition. The most frequently reported BII symptoms include:

  • Chronic fatigue and headaches
  • Poor memory and concentration (“brain fog”)
  • Sleep disturbance
  • Depression and anxiety
  • Persistent joint and muscle pain
  • Breathing and digestive problems
  • Dry mouth and dry eyes
  • Hair loss and frequent skin rashes

One thing we have noticed is that many of the symptoms associated with BII are similar to the symptoms observed with autoimmune and connective tissue diseases, such as lupus and rheumatoid arthritis. Some people who have BII also get diagnosed with a specific autoimmune or connective tissue disorder, but many do not.

Diagnosis of BII

Currently, there are no commonly used diagnostic tests or diagnostic criteria specifically for BII. Furthermore, risk factors for BII are unknown. At this time, we don’t understand why some women with breast implants develop BII. 

A leading theory is that some people are predisposed to having an immune reaction to the materials that are used to build breast implants. This causes inflammation in the body that leads to the symptoms described above.

Treatment of BII

In some (but not all) cases, surgery to remove the breast implants and the scar tissue or “capsule” surrounding the breast implants may improve or resolve BII symptoms. Experts do not recommend replacing the breast implants with new ones. 

Some plastic surgeons recommend a procedure called an “en bloc capsulectomy” where the implant and surrounding capsule are removed in one piece. Others may recommend a “total” (or “complete”) capsulectomy, where both the implant and the capsule are also removed, just not in one piece.

If you are experiencing symptoms that you believe may be caused by your breast implants, it is important to see your primary care physician and your plastic surgeon. If you are considering surgery to address BII symptoms, be sure to ask your plastic surgeon about the risks and benefits of the various surgical treatment approaches. It is also important to remember that removing your implants is not a guarantee that your BII symptoms will disappear.

What does this mean for you?

  • If you are considering getting breast implants for the first time or replacing ones that you already have, ask your plastic surgeon to tell you about BII. Be particularly cautious if you have a personal or family history of autoimmune conditions or allergies, as these are currently thought to be risk factors for BII. 
  • If you think you may have BII, schedule an appointment with your plastic surgeon, or find a board-certified plastic surgeon who has experience treating patients with BII. At the very least, find one who takes your concerns seriously and isn’t dismissive about the symptoms you are experiencing. 
  • If your breast implant surgery was cosmetic and you want to have surgery to have them removed, do not assume that your health insurance plan will cover the surgery costs. If your breast implants were placed after a mastectomy and breast reconstruction, in most cases, private health insurance plans cover surgery to remove breast implants. 

Dr. Valerie Lemaine, M.D., M.P.H., is a top-ranked, board-certified plastic surgeon in private practice in Bloomington, MN. She received her M.D. from University of Montreal, Canada. She completed a reconstructive microsurgery fellowship at Memorial Sloan-Kettering Cancer Center in New York City. Dr. Lemaine then accepted a staff position at the prestigious Mayo Clinic (Rochester, MN) where she taught, practiced and published clinical research. In 2018, she transitioned to private practice and joined Plastic Surgery Consultants and Minnesota Oncology. 

Do you have breast implant illness?

By Dr. Valerie Lemaine, M.D., M.P.H.

Guest contributor

If you’re not quite sure what breast implant illness (BII) is, don’t be alarmed: It is a relatively new term for a condition that isn’t completely understood. Breast implant illness is a term coined by some women and doctors to refer to a wide range of symptoms that can develop after undergoing a surgery with breast implants. 

For example, it could happen after a breast reconstruction or after a cosmetic breast augmentation surgery. BII can occur with any type of breast implant, whether silicone or saline-filled; smooth surface or textured surface; and also with round or teardrop-shaped implants. 

BII symptoms

People afflicted with BII may be impacted in different ways. Also, the symptoms can appear any time after surgery with breast implants. For example, some people develop symptoms almost immediately after surgery, while others develop symptoms years later. 

While there’s no doubt that these symptoms are real, researchers are still trying to determine if they are caused by implants or if they’re related to a separate illness or condition. The most frequently reported BII symptoms include:

  • Chronic fatigue and headaches
  • Poor memory and concentration (“brain fog”)
  • Sleep disturbance
  • Depression and anxiety
  • Persistent joint and muscle pain
  • Breathing and digestive problems
  • Dry mouth and dry eyes
  • Hair loss and frequent skin rashes

One thing we have noticed is that many of the symptoms associated with BII are similar to the symptoms observed with autoimmune and connective tissue diseases, such as lupus and rheumatoid arthritis. Some people who have BII also get diagnosed with a specific autoimmune or connective tissue disorder, but many do not.

Diagnosis of BII

Currently, there are no commonly used diagnostic tests or diagnostic criteria specifically for BII. Furthermore, risk factors for BII are unknown. At this time, we don’t understand why some women with breast implants develop BII. 

A leading theory is that some people are predisposed to having an immune reaction to the materials that are used to build breast implants. This causes inflammation in the body that leads to the symptoms described above.

Treatment of BII

In some (but not all) cases, surgery to remove the breast implants and the scar tissue or “capsule” surrounding the breast implants may improve or resolve BII symptoms. Experts do not recommend replacing the breast implants with new ones. 

Some plastic surgeons recommend a procedure called an “en bloc capsulectomy” where the implant and surrounding capsule are removed in one piece. Others may recommend a “total” (or “complete”) capsulectomy, where both the implant and the capsule are also removed, just not in one piece.

If you are experiencing symptoms that you believe may be caused by your breast implants, it is important to see your primary care physician and your plastic surgeon. If you are considering surgery to address BII symptoms, be sure to ask your plastic surgeon about the risks and benefits of the various surgical treatment approaches. It is also important to remember that removing your implants is not a guarantee that your BII symptoms will disappear.

What does this mean for you?

  • If you are considering getting breast implants for the first time or replacing ones that you already have, ask your plastic surgeon to tell you about BII. Be particularly cautious if you have a personal or family history of autoimmune conditions or allergies, as these are currently thought to be risk factors for BII. 
  • If you think you may have BII, schedule an appointment with your plastic surgeon, or find a board-certified plastic surgeon who has experience treating patients with BII. At the very least, find one who takes your concerns seriously and isn’t dismissive about the symptoms you are experiencing. 
  • If your breast implant surgery was cosmetic and you want to have surgery to have them removed, do not assume that your health insurance plan will cover the surgery costs. If your breast implants were placed after a mastectomy and breast reconstruction, in most cases, private health insurance plans cover surgery to remove breast implants. 

Dr. Valerie Lemaine, M.D., M.P.H., is a top-ranked, board-certified plastic surgeon in private practice in Bloomington, MN. She received her M.D. from University of Montreal, Canada. She completed a reconstructive microsurgery fellowship at Memorial Sloan-Kettering Cancer Center in New York City. Dr. Lemaine then accepted a staff position at the prestigious Mayo Clinic (Rochester, MN) where she taught, practiced and published clinical research. In 2018, she transitioned to private practice and joined Plastic Surgery Consultants and Minnesota Oncology. 

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