Breast implant illness. How serious is it?

Breast implant illness is a phenomenon which is supported by a wealth of anecdotal data but no empiric data. Patient reports a litany of symptoms which they attribute to their implants but the connection is difficult if not impossible to prove via laboratory study.Physician scientists may recognize anecdotal data but unless it is supported by Class I empiric data, it is difficult to place a great deal of faith in it. Clinicians make decision based upon evidence based medicine. That being said, it is easier to identify what one knows rather than what one doesn't.What we do know is that by all available measures today...silicone is safe.Silicone breast implants are among the safest medical devices in use today. These devices are also among the most rigorously studied and tested medical devices currently being used in the U.S. today. It is biologically inert  and in that respect no different than the titanium used for bony fixation. There has been no demonstrated link between silicone and the commonly cited myth of autoimmune disease.As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your question. In short, my answer is this....there is no such thing. This is an urban legend that is pushed by online message boards and blogs with questionable agendas and no scientific expertise. In the scientific literature and FDA investigations, there is absolutely no conclusive evidence that implants lead to any of the supposed illnesses often associated with them. Go forward with your surgeon and do not worry about this.Best of luck!

Thank you for your important question. At this time, there have been many studies published that show there is no cause and effect connection between silicone implants and autoimmune diseases. Regardless of what the research studies have shown, there are some women who feel that their implants have caused illness. In this situation, they may decide to have their implants removed. When considering an augmentation, make sure you find a board-certified plastic surgeon who will speak with you in detail about your goals and will help you decide whether an augmentation is right for you.

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.

Hi Olga.  I will agree with the rest of the consultants here that Breast Implant Illness does not exist.  There is no credible medical science that connects breast implants with ANY medical illnesses.  That is not to say there aren't any complications associated with implants.  Malposition, bottoming out, capsular contracture and other complications are usually due to technical errors at the time of surgery.  You can limit these risks by seeking a consultation with a breast implant expert who is certified by The American Board of Plastic Surgery in your area.

Breast implants are among the most tested of medical devices. No other medical device has been studied to the extent that breast implants have. Extensive studies of tens of thousands of women with breast implants have shown that both saline and silicone implants are safe and do not produce a higher rate of  autoimmune disease. After vigorous evaluation by the FDA, both are approved for cosmetic and reconstructive usage.

The majority of patients having breast augmentations are very pleased with their results. No one should enter into that procedure with the idea that the implants will last forever or that they may never need another breast surgery. There are a variety of reasons why a woman would have a secondary procedure: to alter the size of the implants as the patient ages and the size and shape of the breast naturally change, to correct the effects of pregnancy on the breasts, weight fluctuation, the implant can form a capsular contraction around it which produces a hardening, or the implant may leak. No one can guarantee the life cycle of an implant.

Robert Singer, MD FACS 

La Jolla, California

Hi Olga and thank you for this very timely question.  I have seen many breast implant illness patients in the past few years and I have to say that I do not believe this is a real condition.  These ladies have concerns ranging from menopausal symptoms to double vision to plantar fasciitis which they blame on their breast implants.  Breast implant illness just flies in the face of everything I have learned in school or seen in 26 years of practice.  I do believe that breast implants cause problems in some patients but I do not think they cause systemic illness.  Please see my blog post I have included on this topic.  I would encourage you to read everything you can about this. I have explored much of the online and social media breast implant illness sites and it just makes me shake my head.  The volume and absurdity of the disinformation is astounding.  Coffee enemas anyone?   I truly feel sorry for these patients especially because removing their implants will not help them except for the placebo effect.   If you come away from the web sites and Facebook pages thinking that breast implant illness is real, then don't have implants.  It is foolish to put anything into your body that you will worry about.  With your pear shaped figure, you may be a great candidate for fat transfer to your breasts.  Fat transfer would give you some volume up top and slim you down below the waist. 

This concern first came out in about 1990. Breast implants of silicone were taken off the market for 17 years so further studies could be done. The studies showed that women with implants developed autoimmune disease at the same rate as women without implants, thus implants had nothing to do with the diseases in question. Therefore implants of silicone were released again for use in 2007. However, if you are worried you should not do anything that will cause you ongoing concern as the mental anxiety on a daily basis would not be worth it. BTW, I have been told by a chemist whose expertise was in silicone, that women who wore lipstick had measurable amounts of silicone in their blood and yet no one is writing articles about lipstick poisoning.