BII – All About Breast Implant Illness

Anthony MacQuillan MBBS MD FRCS(Plast)

Symptoms and Causes of Breast Implant Illness

Breast Implant Illness (BII) can be a concern among women who have undergone breast augmentation or reconstruction. BII encompasses a range of symptoms that some women report experiencing after implant surgery. It’s important to note that BII is not officially recognised as a medical condition in clinical practice, leading to debates and challenges in the medical community.

Renowned Consultant Plastic Surgeon Anthony MacQuillan has successfully guided hundreds of patients through their breast augmentation journey, ensuring desired outcomes and providing support throughout the recovery process.

Types of Breast Implants

Women considering breast implants can choose between two primary types: silicone and saline. Silicone implants are filled with a silicone gel and are known for providing a more natural look and feel, closely resembling breast tissue. On the other hand, saline implants consist of a silicone shell filled with sterile salt water. They are generally firmer and considered safer by some, as they can be filled after being inserted, allowing for smaller incisions and adjustments in size.

Additionally, within these categories, variations exist in terms of shape (round or anatomical), texture (smooth or textured), and profile (how much the implant projects from the chest wall). The choice among these options is typically based on individual preferences, body type, and the advice of a plastic surgeon.

Reasons for Choosing Breast Implants

Women opt for breast implants for a variety of reasons, with each individual’s decision shaped by personal, aesthetic, or medical factors. Cosmetic augmentation remains the most common reason, why individuals seek to enhance the size and shape of their breasts for personal satisfaction and improved body image. However, it’s important to approach this decision with realistic expectations and a clear understanding of potential risks and benefits.

Breast reconstruction is another significant reason for choosing implants. Women who have undergone mastectomy, often due to breast cancer, may choose implants as a part of reconstructive surgery to restore breast shape. This can be an integral part of the emotional and physical healing process after cancer treatment.

Some women may undergo implant surgery for correction of asymmetry or congenital deformities, where breast implants can play a role in achieving symmetry and a more typical breast shape.

What is Breast Implant Illness?

Breast Implant Illness (BII) is a controversial topic in the field of plastic surgery and patient advocacy. It is not an officially recognised medical diagnosis, but rather a term used by patients and some healthcare professionals to describe a constellation of symptoms believed to be associated with breast implants. The challenge in defining BII lies in the diversity and non-specific nature of the symptoms reported, which can vary widely among individuals and overlap with other conditions.

Commonly reported symptoms include fatigue, chest pain, hair loss, headaches, chills, photosensitivity, chronic pain, rash, body odour, anxiety, brain fog, sleep disturbance, depression, neurologic issues, and hormonal issues. Importantly, these symptoms are subjective and can be influenced by a variety of factors, making it difficult to establish a direct cause-and-effect relationship with breast implants.

Symptoms of Breast Implant Illness

The symptoms attributed to BII are broad and can affect multiple body systems, leading to significant distress and impairment in quality of life for those experiencing them. For instance, chronic fatigue and cognitive difficulties like brain fog can impact daily functioning and work productivity. Joint and muscle pain can limit physical activity and contribute to a sedentary lifestyle. Psychological symptoms such as anxiety and depression can arise from the chronic nature of the illness and the uncertainty surrounding it.

It’s important to note that these symptoms are anecdotal and not universally experienced by all individuals with breast implants. Furthermore, because these symptoms can be common in the general population and associated with various other conditions, pinpointing breast implants as the sole cause is challenging.

Breast Implant Illness Controversy

The medical community is divided on the issue of BII. Some practitioners acknowledge the symptoms reported by patients but caution against hastily attributing them to breast implants without further scientific evidence. Others are more sceptical, citing the lack of robust clinical research establishing a clear causal link between breast implants and the reported symptoms.

Research in this area is complicated by various factors, including the subjective nature of the symptoms, the lack of a standardised definition of BII, and potential confounding factors like pre-existing conditions and environmental influences. Some studies have explored the potential for silicone or other components of implants to cause an immune or inflammatory response, but findings have been inconclusive.

The controversy over BII also stems from the personal and emotional dimensions of the issue. Many women feel their concerns are not taken seriously by the medical community, leading to feelings of frustration and helplessness. This has spurred patient advocacy groups and social media communities where individuals share their experiences and support one another.

The Impact of Breast Implants on Health

The relationship between breast implants and health has been the subject of extensive scientific research, albeit with mixed results. Numerous studies have sought to understand whether breast implants increase the risk of specific diseases or conditions. For instance, studies have explored potential links between silicone implants and autoimmune diseases, with some suggesting a possible association while others find no significant correlation.

Research has also focused on the physical complications related to breast implants, such as rupture, capsular contracture, and infection. Implant rupture can lead to the leakage of silicone into surrounding tissues, potentially causing pain and changes in breast shape. Capsular contracture, where scar tissue forms tightly around the implant, can lead to discomfort and aesthetic issues. While modern implant designs and surgical techniques have sought to minimise these risks, they remain pertinent concerns.

In addition, there has been growing attention on Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a rare but serious type of cancer associated with certain types of textured breast implants. This has led to regulatory actions and heightened awareness among both patients and healthcare providers.

The FDA’s Stance and Regulations

The U.S. Food and Drug Administration (FDA) plays an important role in the regulation and oversight of breast implants. In response to concerns about the safety of breast implants, the FDA has undertaken several actions, including updating labelling requirements to ensure patients receive clear information about the risks associated with breast implants. The FDA has also called for more rigorous post-market studies by implant manufacturers to better understand long-term outcomes.

The agency’s stance on BII specifically is one of cautious observation. While acknowledging the reports of symptoms by patients, the FDA emphasises the need for more scientific data to understand any potential relationship between breast implants and these symptoms. This approach reflects the complexity and uncertainty surrounding BII, balancing patient concerns with the current state of scientific evidence.

Diagnosis and Management of Breast Implant Illness

Diagnosing Breast Implant Illness presents unique challenges due to its lack of recognition as a formal medical condition and the non-specific nature of its symptoms. Currently, there are no standardised diagnostic criteria or specific tests that can definitively diagnose BII. This ambiguity often leads to a complex and frustrating journey for patients seeking answers. Physicians typically rely on a process of exclusion, ruling out other potential causes of the symptoms, such as autoimmune diseases, hormonal imbalances, or psychological factors.

The subjective nature of BII symptoms means that diagnosis heavily depends on patient-reported experiences. This requires a thorough patient history and often involves consultations with multiple specialists, including immunologists, rheumatologists, and mental health professionals. The challenge is compounded by the fact that many of these symptoms are common in the general population and can be attributed to a variety of other health issues.

Treatment Options

The management of Breast Implant Illness is as varied as its symptoms and largely individualised. Since there is no consensus on the cause of BII, treatment approaches focus on symptom relief and patient support. Some patients find improvement with conventional treatments like pain management, anti-inflammatory medications, and lifestyle changes such as diet and exercise modifications.

Mental health support is also important, as the ongoing struggle with unexplained symptoms can lead to anxiety, depression, and a sense of isolation. Counselling and support groups can provide a valuable space for patients to share their experiences and coping strategies.

In many cases, patients opt for explant surgery – the removal of breast implants – in the hope that it will alleviate their symptoms. While some patients report significant improvement post-explant, it’s important to note that this is not a guaranteed solution for everyone. The decision to undergo explant surgery should be made after careful consideration and discussion with a qualified plastic surgeon, weighing the potential benefits against the risks and impacts of another surgical procedure.

The Role of Surgery in BII

Explant surgery has become a focal point in the discussion around Breast Implant Illness. For many patients, it represents a hopeful solution to their ongoing health struggles. The procedure involves not only the removal of the implants but often also the surrounding scar tissue (capsulectomy). Some patients opt for additional reconstructive procedures to restore the natural shape of the breasts post-explant.

The decision to undergo explant surgery is deeply personal and can be influenced by a variety of factors, including the severity of symptoms, duration of implant placement, and individual health goals. It’s important for patients to have realistic expectations and understand that while many report relief after explanation, it is not a guaranteed cure for BII symptoms.

Alternatives to Breast Implants

For those considering alternatives to breast implants after explant surgery or for those opting not to have implants in the first place, there are several options. Fat grafting, also known as fat transfer, is one option where fat is taken from another part of the body and injected into the breasts. This method can provide a modest increase in breast size and a natural look and feel.

Some women choose to embrace their natural body shape post-explant, focusing on body positivity and acceptance. Others may opt for external prostheses or special bras to achieve the desired breast contour without surgery.

FAQs about Breast Implant Illness

What is Breast Implant Illness (BII)?

  • Breast Implant Illness refers to a range of symptoms that some women report after undergoing breast implant surgery. These symptoms can include fatigue, joint pain, cognitive difficulties, hair loss, and more. It’s important to note that BII is not officially recognised as a distinct medical condition and is currently a subject of ongoing research and debate in the medical community.

Are certain types of breast implants more likely to cause BII?

  • Currently, there is no conclusive scientific evidence linking specific types of breast implants to a higher risk of BII. Both silicone and saline implants have been associated with reports of BII symptoms. However, ongoing research is needed to fully understand if certain types or characteristics of implants may contribute more significantly to the development of these symptoms.

How is Breast Implant Illness diagnosed?

  • Diagnosing BII is challenging, as there are no standardised criteria or tests. Generally, diagnosis involves ruling out other conditions that could cause similar symptoms. Healthcare providers may conduct a variety of tests to exclude other potential causes and consider the symptoms in the context of the patient’s overall health and history with breast implants.

Can removing the implants cure BII?

  • Some women report a significant improvement in symptoms after having their implants removed, a procedure known as explant surgery. But improvement is not guaranteed for everyone, and the decision to undergo explant surgery should be made after careful consultation with a healthcare provider. It’s also important to consider the potential risks and emotional impacts of additional surgery.

What should I do if I think I have Breast Implant Illness?

  • If you believe you might be experiencing symptoms of BII, it’s important to consult with a healthcare professional, ideally one who is familiar with BII. They can help assess your symptoms, explore potential causes, and discuss possible treatment options, including the potential benefits and risks of explant surgery. Keeping a detailed record of your symptoms and their impact on your daily life can also be helpful during your consultation.

Further Reading about Breast Surgery with Consultant Plastic Surgeon Anthony MacQuillan

Medical References about Breast Implant Illness