How common is breast implant illness?

Thank you for your question and you are prudent to being do your research. The complex subject of BII is not well understood, and I happen to be on staff at the very hospital in Tel Aviv, Israel where the immunologist who first coined the term and published on the subject is on staff and a colleague. We agree to disagree on several matters, as you might imagine.

That said, here is what we know today, and more importantly what we do not know. What we know is that there are millions of women the world over who have breast implants for for cosmetic and reconstructive purposes, the vast majority of whom are enjoying an improved quality of life because of their surgery. Virtually ALL implants (saline or silicone gel filled) have a silicone ('silastic") envelope whose inner contents may be either saline (salt water) or silicone gel. Silicone is a compound made up on one silicone atom ("Si") on the periodic table of elements and two oxygen atoms ("O") and its formula is therefore "SiO2". Silicon, the atom, is the second most common element on planet earth after carbon, and is everywhere in our environment, including our soil and our drinking water, not to mention nail polish, hair spray, many body lotions and facial creams, sun screen, etc. Oxygen doesn't need any explanations.

BIAI (Breast Implant Associated Illness), if such a diagnosis exists, consists of what appears to be a very long list of signs and symptoms that on their surface seem totally unrelated, but according to the immunologist, rheumatologist, and functional medicine community, may all be an indication of the body's immune response to an immune stimulant or trigger. We cannot state with any certainly that silicone is the culprit in any given patient, and more importantly, these symptoms are overall very rare compared to the number of women who have breast implants. More importantly, women can have many of these symptoms and signs without ever having had a breast implant in their body.

Therefore, as you can see, the subject is both confusing and complex and we certainly do not have all the answers. If you yourself are a highly allergic person, or have a family history of various autoimmune conditions such as lupus, rheumatoid arthritis, scleroderma, Sjogren's syndrome, etc. you may want to be very thoughtful about undergoing surgery since you might be one of those rare patients who develops odd symptoms after you breast augmentation.

However, after doing all of your research on your own, it is probably best to consider a consultation with a board certified plastic surgeon who can advise you in person on all of your options. The take home message is that based on the statistics alone, a breast implant appears to be an extremely safe device that has improved the quality fo life for countless patients. Best of luck to you.

The textured breast implants are linked to breast implant associated-anaplastic large cell lymphoma (BIA-ALC), a cancer of the immune system. The FDA reports that BIA-ALCL may develop in 1 in between 3,817 to 30,000 women with textured breast implants (Clemens et al, 2017; Loch-Wilkinson et al, 2017; De Boer et al, 2018). As of this date, the risk appears to be very small. In most cases, BIA-ALCL is found in the scar tissue and fluid near the implant but can be widespread. The most common test for ALCL is to take a biopsy of an enlarged lymph node and check it for lymphoma cells. After three years, 93 percent of BIA-ALCL patients are disease-free when the condition is detected and treated early, according to American Society of Aesthetic Plastic Surgery data. The human leucocyte antigens (HLA) test can be requested through your PCP and involves a standard blood sample using a small needle. The blood sample is then sent to a lab for analysis. If the blood results are HLA-B27 or HLA DR52 positive, it means you have a rare HLA gene and therefore you are very susceptible to autoimmune diseases from silicone exposure.

Breast implant illness has becoming more recently discussed over the years with social media. The exact incidence of Breast implant illness is not accurately reported. Initially, when silicone implants were pulled from the market and prospective studies were performed; the data at that time showed autoimmune symptoms were similar for women augmented and not augmented. With more time and studies, hopefully more data can be obtained.
Fat grafting to the breast is another option for breast enhancement in patients interested in smaller breast augmentation without implants.