What is your opinion on women wanting their breast implants removed due to illness? Why don't doctors mention this procedure to women wanting their saline breast implants out? I have women contacting me on a daily basis asking who they should see to have their saline breast implants removed since they have the same exact symptoms as I had prior to having mine out. Most doctors don't even mention getting the en-bloc and leave the capsule in. I find the women who don't get them out en-bloc only get sicker while the one's like myself who do get this extra procedure gain most of their health back. What is your opinion on this?
Removing Breast Implants Due to Illness
Doctor Answers (11)
Explantation due to illness in saline implants
Illness and saline implants
Implant Capsule Problems
Usually the plastic surgeon who placed the implants can also remove the implants for cosmetic, psychological, or medical purposes. Saline implants usually have no significant shell since they do not have any silicone gel present, but a thick capsule around a saline implant may be removed if it is present. When implants are placed we do a medical history review. If there are no prior medical issues or illnesses it has been accepted that implants will not cause any illnesses. Why are patients contacting you specifically? Are you a web host site for breast implant questions?
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Not sure what you are asking
Breast implants are now among the most thoroughly researched medical devices in history- there is abundant evidence of their safety and no reason to any longer believe they might be implicated in any systemic illness. It is possible, as my colleague points out below, that the saline may become contaminated with bacteria, causing the patient to feel ill, but this is a rare occurrence.
Whether or not to remove the implant capsule at the time of implant removal is something that should be discussed between the patient and surgeon in preparation for the procedure, and would be affected by the circumstances leading the patient to seek removal of her implants.
Question not clear
You do not mention what illness you are referring to nor what affect to your health you believe your implants are causing. Also, it is not clear what the capsule has to do with your question. In general, saline implants are not known to cause specific diseases or illness themselves although there are very rare anecdotes about contamination of the saline with various unusual organisms both bacterial and fungal. Explantation of the implants can be contemplated under a number of scenarios and the ramification of both the explantation and the failure to explant should be discussed between the surgeon and patient. However a cause and effect link between saline implants and a specific disease process must be clear before a recommendation for explantation can be made. Of course, just as a patient electively chooses to undergo augmentation, she has the right to voluntarily undergo explantation but should be informed of the consequences of such action including breast deformities, scars required to restore form and shape, and possible emotional depression due to body image issues.
I have removed implants in a few women who wanted them out for these kinds of reasons. I did tell them that afterward things might not change with the illness about which they were concerned. This has usually been the case. With this being said, I feel it is the patient's body and I will do what she requests as long as it does not seem to be harmful.
John Di Saia MD
What exactly is your question?
What exactly is your question? You seem to making some generalizations and it is unclear what your issue is. If you are asking about the association between implants and illness, there is no scientific evidence to support that claim. However, many women do choose to have their implants taken out if they have coincidental autoimmune or other concerns. When the implants are taken out, in most cases the capsule is left in place. However, if the patient wants that capsule out and it is surgically possible, then there is no problem taking out the capsule. However, if the patient has very thin skin, then sometimes it is dangerous to take out the capsule. Also, there is a higher risk of bleeding when the capsule is taken out. These are all issues that should be discussed with your surgeon ahead of time. If you are having some issue with your surgeon or a communication breakdown, then I suggest that you seek a second opinion from another surgeon. Good luck.
Doesn't make sense
There is no scientific evidence to date that implants of any kind cause any illness in women. The past silicone implant episode, in the early 1990's, prompted several studies that demonstrtaed no relationship between silicone implants and illness. Saline devices have been used all along and were never implicated as causing any illnesses. The FDA would never allow this to occur as you have seen by the silicone episode. It took over 10 years to get gel devices back into use in the U.S. after the science and trials proved their safety.
Removing saline devices and leaving their capsules should not make any patient "symptoms" worse. This does not make sense. These women should be evaluated by their physicians to make sure they receive the appropriate diagnosis and treatment.
Implant removal and health
There have been many studies that have shown no association of collagen vascular disorders with breast implants. This is what originally kept silicone implants off the market for about 15 years.
No conspiracy exists
Removing breast implants and leaving them out is a big deal. It may leave the breasts deformed. On the other hand, science has proven that the implants are not linked to systemic illnesses. I do acknowledge (and have on this site before), that despite this, some women seem to experience improvement in happiness and health after removal of implants- I have seen this, but it is very rare.
In my practice, I tell patients exactly the same thing. If they want the implants out, I am happy to do it, as long as they understand that they may get no relief, and they may get deformed breasts. In such cases, I always do a capsulectomy (what you call en bloc).
I would also add, I haven't had much demand for explant with capsulectomy since the silicone implant scare in 1992.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.