Why do breast implants make some women sick and not others?

Thank you for your question!I believe when you say sickness - you are referring to autoimmune diseases which appears in multiple blog articles on the net. These sources are not trustworthy or accurate. You will also notice that the majority of the articles on the net will site SILICONE implants as the culprit. Even if you agree with those articles, please don't transfer the blame to saline implants.Please understand that there is NO link
between autoimmune diseases and silicone implants according to current research. You see, we are naturally scared of
things we do not know or things we do not understand. It is okay to feel concerned
especially because there still isn’t much information on the prevalence of
autoimmune disease after breast augmentation surgery. You see, ASSOCIATIONS have been found in a very small subgroup of patients in multiple old studies,
but there is still no conclusive evidence that proves that silicone breast
implants CAUSE autoimmune diseases. Associations don't tell us anything special because you can find an association between anything such as things like eye color and your likelihood to come into a car accident, or the emotional state of mind and the color of shirt you are wearing. To make associations meaningful, 2 things are needed - 1) the association should be strong, and 2) there should be a logical and scientific explanation for the connection. Without this, associations are nothing!As such, calculating your chances of implants making you sick cannot be done, because it is not proven that implant cause sickness. Several studies implicate that there is no increased risk
to develop autoimmune diseases after silicone breast implant insertion which is
why the FDA lifted the ban on these implants in 2006. So, educating ourselves
in this field is important so that we do not take things out of context.Also, please note that compared to the
number of people who get BBAs each year (over 300,000), very few (less than 1%)
actually experience autoimmune disease-related clinical symptoms. Based on
current evidence from CLINICAL TRIALS, we can say that silicone breast implants
are safe, especially with the new current generation implants. Below, I describe 3 research papers
from between 2015-2016 which suggest that silicone implants MAY be ASSOCIATED with
autoimmune disease-related SYMPTOMS, but the studies are NOT long-term clinical
trials. Please note that the studies only found a link between the silicone
implants and autoimmune disease-related SYMPTOMS, but NOT with the autoimmune
diseases itself. 1) In the 30 year comparative study by
Colaris et al., 100 patients who had autoimmune/inflammatory syndrome induced
by adjuvants (ASIA) due to silicone implants were diagnosed in 2014 in
Netherlands and were compared with another set of 100 patients with the same
diagnosis between the years 1985-1992 in USA. The study found that most
patients at both periods of time (1985 and 2014) had clinical symptoms required
to diagnose ASIA: chronic fatigue, arthralgia (joint pain), myalgia (muscle pain),
cognitive impairment, pyrexia (fever), and sicca (dry eyes). They also found
that 52% of patients in both groups had allergies. In the 2014 group, 34
patients were diagnosed with an autoimmune disease. They found that from the 54
patients who underwent removal of their silicone breast implant, 50 % (n = 27)
of the patients experienced improvement of complaints after explantation of the
implant. This also means that 50% did not, so we still can’t say that the
implant is the problem. The authors found that the median time it took for
patients to have clinical symptoms was 4 years. The median time between implant
and diagnosis was 13 years. The authors of the study conclude that even though
changes were made to silicone implants during the past 50 years, the presence
of similar symptoms in the 2014 group links silicone implants to autoimmune
diseases. Colaris, M. J. L., Boer, M. de, Hulst, R. R. van der, & Tervaert, J.
W. C. (2016). Two hundreds cases of ASIA syndrome following silicone implants:
a comparative study of 30 years and a review of current literature. Immunologic
Research, 1–9.2) In a study by Boer et al., patients
with implants who had nonspecific complaints such as joint pain, muscle pain,
and fatigue had their implants explanted. This was done to see if explantation
of silicone implants will reduce the clinical symptoms so that it can be
advised as an effective therapy for these patients. The study found that
explantation improved silicone-related complaints in approximately 75% of the
patients (469 out of 622). Autoimmune diseases improved in 56% of patients (10
out of 18) only when removal of implants was coupled with immunosuppressive
therapy. Boer, M. de, Colaris, M., Hulst, R. R.
W. J. van der, & Tervaert, J. W. C. (2016). Is explantation of silicone
breast implants useful in patients with complaints? Immunologic Research,
1–12.3) In a
review by Goren et al., 4 groups of patients were suggested to be at risk or a
predisposition of silicone-implant related autoimmune disease and these
patients should not be considered for silicone implantation just to be safe. 1st
group are those with prior documented autoimmune reaction to an adjuvant such
as a vaccination, implant, etc. 2nd group are those with established
autoimmune conditions such as Graves disease, type 1 diabetes, rheumatoid
arthritis, etc. 3rd group are those with a history of allergic
conditions such eczema, hay fever, pollen and dust allergy, drug allergy and
rubber or latex allergy as 75% of patients whom experienced symptoms of
autoimmunity to silicone had prior allergies. 4th group are those
who are prone to develop autoimmunity due to genetic linkage or prevalence in
the family. Several studies have acknowledged increased tendency for
development of autoimmune diseases among relatives of patients with rheumatoid
arthritis, multiple sclerosis, systemic lupus erythematosus, and more. In one
case report 3 sisters developed fatigue, arthralgia, myalgia, and sleep
disturbances after they underwent silicone implantation and there symptoms
alleviated after being given saline-filled implants.Goren, I., Segal, G., & Shoenfeld, Y. (2015). Autoimmune/inflammatory
syndrome induced by adjuvant (ASIA) evolution after silicone implants. Who is
at risk? Clinical Rheumatology, 34(10), 1661–1666.All three papers are NOT enough to say
that silicone breast implants CAUSE autoimmune diseases. All that the studies
show is that certain symptoms which can have multiple causes (i.e, muscle pain,
fatigue, joint pain, and dry eyes) seem to get reduced after explantation of
the implants in 50% to 75% of these patients. As you can see, neither study
specifically linked autoimmune disease with breast implants. This is why we
should not take things out of context and negatively connote silicone implants as
unsafe. I advise you to share your concerns
with a board-certified plastic surgeon, and hopefully they can clear any
misunderstanding and misconception. If you are worried a lot about silicone
implants, then opt for saline implants or IDEAL implants.Hope this helps and clarifies the current research out there.

Breast implants themselves do not make patients sick, however, post-anesthesia nausea is not uncommon. It is caused by the anesthetic drugs or the pain medications and is aggressively treated. Any symptoms usually resolve by the first post-op visit.After breast augmentation there are often sensations such as tightness, burning, sharpness, tearing, and pulling can come and go as the tissues heal and the swelling and inflammation subsides. These sensations are usually more intense or different on one side versus the other. Most often these sensations are due to irritation of nerves in the post-operative period and not any source of concern. Common complications of breast augmentation can include bleeding, infection, healing issues, nipple issues, contour deformities, fluid collections, and capsular contracture. The being said, most patients do very well and are satisfied with their choice to enhance their breasts. See the link below for more info on breast augmentation. A detailed examination will help delineate the best surgical treatment. Consultation with a surgeon certified by the American Board of Plastic Surgery would be the next best step. See our link below for more information.

The simple answer is that they don't. There was a suggestion in the 1990's that they might, resulting in a massive overreaction from the FDA (and even a huge payout in court) but subsequent investigation has shown absolutely no link between silicone implants and chronic disease. You can rest assured that, as long as the manufacturer adheres to the strict controls necessary for FDA approval, your implants would never 'make you sick'

In the 1990s media reports about silicone breast implants causing chronic systemic disease were overreacted to, resulting in public panic, the FDA removing them from the market, companies going bankrupt, and unnecessary surgeries being performed to remove them from patients bodies.  These reports were later rigorously examined through comprehensive scientific studies and it was found that there was in fact no link between silicone breast implants and autoimmune disease.  Following this, the implants were placed back on the market.  A fascinating account of the unfounded claims that stoked these events can be found in the book Science on Trial by Marcia Angell.  The bottom line is that numerous stories still circulate about how silicone breast implants make patients sick, but this has scientifically be shown over years of study that they do not cause systemic illness and that they are in fact safe.In order to get a qualified, ethical, and expert opinion on your surgical options and expectations, always have an in-person consultation with a plastic surgeon certified by the American Board of Plastic Surgery.

Best of luck,Keith M. Blechman, MDNew York, NY

Thank you for the question. The vast majority of patients who undergo breast augmentation surgery are pleased with their outcomes.  However, as you mentioned, there are  patients who feel that their breast implants contribute to a variety of illnesses.    You will find, that there is no consensus among plastic surgeons, whether or not there is a  link between breast implants and the medical conditions  of concern.
I encourage patients in my practice who have concerns about "breast implant illness" to undergo complete medical workups, and seek second/third opinions (internists, neurologists, rheumatologists...) as needed. Generally speaking, best not to assume that the breast implants are the cause of their "sickness".
  Having said the above, I think that as physicians, it is important to keep an open mind (even though there is no definitive scientific demonstration of breast implants and   specific illnesses except for a very rare lymphoma) and remember that we may very well not have a full understanding of breast implants and the potential interactions that may occur with each patient's unique biology (for example, exactly how a specific patient's immune system will respond to breast implants as a foreign body).  
Best wishes.