What is Breast Implant Illness?
Breast Implant Illness (BII) is the common term for what was initially named Human Adjuvant Disease, which related to concerns that breast implants might be affecting the health of women. Since 1964, there have been several small medical study reports concerning Breast Implant Illness and how removal of the implants affected women’s health.
These reports usually demonstrated no changes in an individuals blood work that was consistent with the patient’s symptoms. However, in 1992, in spite of medical studies showing no solid evidence of BII, a large number of media reports forced the FDA to place a moratorium on silicone gel implants. Saline implants (silicone shell filled with saline [salt water] were never withdrawn from the market.
Patient complaints related to Breast Implant Illness have included:
- Central Nervous System – memory loss, brain fog, headaches, migraines
- Immune – Autoimmune including Raynouds, Rheumatoid, Sjogrens, Toxic Shock and more
- GI and Urinary – frequency, liver & kidney problems, reflux, gastritis, weight gain, leaky gut
- Skin – dry skin, hair loss, rashes
- Psychological – anxiety, depression, panic attacks
- Heart – palpitations, heart pain, shortness of breath, cough
Several studies have tried to correlate rheumatic type and onnective tissue type illnesses to breast implants and a true statistically significant correlation has not been found. Because of that, the FDA cleared silicone implants for cosmetic uses in 2006.
Results of Breast Implant Removal
There are several studies that have looked at how patients have done clinically after the removal of their implants for BII.
In a Canadian study, patients who underwent implant removal were compared to a control group of other plastic surgery patients who did not have implants. The group without implants actually had higher evidence of antinuclear antibodies (a sign of immune disease) than the BII group.
In the study, the scar tissue around the implants (capsule) was removed. This is called a capsulectomy. It was noted that 42% of the capsules had bacterial colonization. In the BII group with no signs of immune disease, 90% improved their symptoms following removal. In the group with signs of rheumatic disease, but not autoimmune disease, their symptoms improved for a short time and then they all relapsed. Finally, in the group with autoimmune signs but no rheumatic signs, none improved.
As confusing as this picture is, some surgeons do report that their patients feel better following implant removal for BII
Our Experience
In 1992, during the initial FDA moratorium, Dr. Schneider treated over 200 patients with concerns of BII. He removed both silicone and saline implants from patients. In his experience, about 50% of patients subjectively felt better. This is consistent with what other surgeons have reported.
In 95% of patients who underwent removal without any other procedure to the breast (breast lift, fat injection, reconstruction), their breasts basically returned to their pre-augmentation shape.
Since BII has made its recurrence in the press and social media, Dr. Schneider continues to offer implant removal and capsulectomy for patients with BII complaints.
Our Approach
Check Your Breast Implants
Patients with complaints of a variety of symptoms including dry itchy skin, rashes, aches and pains, and loss of mental acuity, often go from physician to physician without receiving any comprehensive care.
In our office, patients who are seen with BII complaints undergo a thorough history, breast exam, battery of blood tests specifically recommended for BII. In some cases, a mammogram, sonogram and/or MRI may be recommended. Based on these results, and a discussion with the patient, breast implant removal surgery may be recommended.
Because we do not know for certain the exact cause of breast implant illness, Dr. Schneider believes that anything that has the potential to be causing the problem should be removed when removing the implant. As such, he usually recommends the removal of the implant and capsule that surrounds the implant. This is typically performed through the patient’s preexisting breast scar.
The procedure typically takes 60-90 minutes to perform and is followed by a fairly quick recovery and return to work. Drains are not necessary and in most patients, the incisions are closed with internal dissolvable sutures that do not need to be removed. Some patients may choose to have a breast lift at the same time, however, for most patients, they are pleasantly surprised that their breasts return to their pre-augmentation shape.
