Rosacea/eczema and breast implant illness

Question

I've been atopic (eczema, allergies, asthma) my whole life. All of these issues have gotten better with age (I'm now in my mid-20s), but have not subsided entirely. Recently, however, I also developed rosacea. I've been considering a breast aug for awhile now and am wondering if having eczema/rosacea puts me at a higher risk of getting BII due to being autoimmune related. I know that the risk of BII is small across the board, but in your experience, do pts with rosacea/eczema have a higher risk?

Ram Kalus, MD, FACS · Answer

Thank you for your insightful question. Unfortunately there is no solid answer. BII is poorly understood yet the current thinking is that a certain subset of women may have their breast implant trigger some sort of body immune response. Since your immune system is already somewhat “primed” with your atopic history, it is a consideration: I believe most of plastic surgeons (myself included) would not disqualify you from a breast augmentation, nor should your history be considered a contraindication. Rather, it should be taken into consideration but the ultimate decision is between you and your plastic surgeon.

The he vast majority of women who undergo breast augmentation report a significant enhancement in their quality of life, and state they would do it all over again without hesitation. Those who report BII are a vocal minority.

Please consult with an experienced board certified plastic surgeon whose results appeal to you and be open to the possibility that more than one opinion may serve your best interests. Good luck to you.

Donovan Rosas, MD · Answer

Breast Implant Illness is a difficult topic of discussion. There are many patients who claim a myriad of systemic symptoms attributed to their implants. However, no study has shown a cause and effect link. There is no lab study to confirm the diagnosis.

Anecdotally, some patients pursue removal and report resolution of symptoms. Yet many find no relief.

With regards to your specific question, there is no scientific data available to suggest avoidance of augmentation. This an area which will likely need more study in the future. That being said, silicone gel breast implants are among the most extensively studied medical devices in existence. There has never been a causative link demonstrated.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Daniel Barrett, MD · Answer

Dear mdmd2170,

I understand your concern. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gerald Minniti, MD, FACS · Answer

Systemic symptoms from breast implants, SSBI, formally BII, has no evidence of being anything more than psychosomatic in nature. Recent careful, systematic, prospective studies have shown that there is nothing in a breast implant that can accumulate in the body, or even in the scar capsule, which is why 'en bloc capsulectomies' are unnecessary. People simply 'get better' when their implants are taken out with no removal of scar capsules. FDA approval of silicone gel filled breast implants in 2006 was based on studies of over 120,000 women for 14 years, and found no increase risk of autoimmune based disease, but also no evidence of subjective symptoms that is now part of an umbrella term BII. You are safe from SSBI, regardless of being atopic. The number one risk of 'BII' is the preference to get medical information from the internet instead of a physician, and a propensity for believing conspiracy theories.

Ted Eisenberg, DO, FACOS, FAACS · Answer

In my experience, augmentation on my patients did not make their rosacea/eczema worse. Always best to check your surgeon's experience with this. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Connie Hiers, MD, FACS · Answer

In my experience, I have not seen an increase of BII with rosacea or eczema. Do be checked for food and other allergies, because allergies do flair up both.  If you choose implants, consider saline to decrease the amount of foreign material in your body, and avoid large heavy implants.

Camille Cash, MD · Answer

BII is what is considered a diagnosis by exclusion, meaning there is no specific test for it.  It is categorized by a vague collection of symptoms such as fatigue, brain fog, and joint and muscle pain.  Some patients decide to have their implants removed and report improvement in their symptoms while others report no change.  There is no known direct link between rosacea and those with breast implants.  I've included a video that discusses BII that I hope you find helpful.

Rosacea/eczema and breast implant illness

Answers (7)

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