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BREAST IMPLANT ILLNESS (BII)

Mersad Alimoradi 20 Sep 2021
BREAST IMPLANT ILLNESS (BII)

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Breast implant illness (BII) is a large constellation of symptoms rarely reported in women with breast implants. 

The list contains a wide variety of complaints affecting nearly every aspect of life: joint pain, brain fog, memory troubles, sleep troubles, breathing problems, breast pain, and others. All thought to be related to breast prostheses.

Doctors have only recently acknowledged that breast implant illness is a valid medical diagnosis. Before this, many of the symptoms were dismissed and ill-treated. 

We still don't know what the cause of breast implant illness is, however, researchers are actively trying to find out. 

Keep reading to learn more about breast implant illness, its symptoms, diagnosis, and possible treatment. 

What is Breast Implant Illness? 

Breast implant illness (BII for short) is a group of self-reported symptoms in women who get breast augmentation or breast reconstruction with silicone breast implants.

It is still not an official medical diagnosis, however, the global plastic surgery and medical society now acknowledge its existence. It can be categorized as an autoimmune inflammatory disease. 

Another name for breast implant illness is autoimmune/inflammatory syndrome induced by adjuvants (ASIA). This is because some evidence suggests that an ongoing chronic inflammation around the implants might be responsible for the patients' autoimmune symptoms. 

The systemic symptoms can be cognitive symptoms (e.g. memory troubles) or physical symptoms (e.g. muscle pain, joint pain), and the severity and types of symptoms differ from one patient to another. 

Breast implant illness can occur regardless of the implant type you have - saline implants,  silicone implants, textured implants, smooth implants, round implants, or anatomical implants. 

What Causes Breast Implant Illness?

There's no known single cause of BII yet. However, there are several theories as to why it happens:

  • Immune reaction against the implants: some believe that the body reacts against foreign materials like silicon or polyurethane used in silicone and saline implants. Some experts point to the fact that the body may react negatively to the presence of metal particles in the implants. 

  • Auto-immune disorder: others think that the immune system attacks itself when exposed to certain substances such as chemicals breast implant shells. 

Whatever the reason, breast implant illness occurs when your body mounts an inflammatory response to something inside the implants. The exact trigger remains unknown but we do know that it usually starts within weeks to months following surgery. 

This inflammatory response leads to the release of chemical mediators into the blood and brain, leading to the reported physical and mental symptoms. 

What Are the Symptoms of Breast Implant Illness? 

The symptoms of breast implant illness are not well characterized. The way this disorder affects each individual is different. According to the FDA, the most reported symptoms of breast implant illness include: 

  • Generalized weakness and fatigue 
  • Trouble concentrating (brain fog) 
  • Joint aches (arthralgia) 
  • Anxiety 
  • Hair Loss 
  • Depressed mood 

Other reported breast implant illness symptoms include:  

  • Memory Problems 
  • Sleep Troubles 
  • Difficulty Breathing 
  • Painful Breasts 
  • Headaches 
  • Skin rashes 
  • Nausea 
  • Dizziness 
  • Muscle aches 
  • Insomnia 
  • Heart palpitations 
  • Shaky hands 
  • Sweating 
  • Feeling cold 
  • Shortness of breath 
  • Tingling sensation in arms & legs 
  • Chest pains 

Breast implant illness symptoms are still not well categorized and are highly variable from patient to patient. If you have breast implants and have been experiencing any of these symptoms lately, then you might have breast implant illness. 

How Common is Breast Implant Illness? 

Since BII/ASIA is still not an official medical diagnosis, we still don't have enough data regarding its prevalence. 

Experts believe, however, that it's not a very common complication of breast implant surgery. There are several online communities with thousands of women claiming to have symptoms of breast implant illness. Nevertheless, there's still no standardized testing and diagnostic criteria, and we cannot know for sure how common breast implant illness is. 

What are the Risk Factors For Breast Implant Illness? 

Since it's still a newly emerging illness, the risk factors for BII are still not well known. It is thought that a family history positive for one of the following might put you at risk of ASIA: 

The cosmetic breast implant type (silicone-gel breast implants vs saline breast implants) is not known to be a risk factor for BII. 

How is Breast Implant Illness Diagnosed? 

The diagnosis of BII poses a real challenge to plastic surgeons and doctors.

The symptoms of BII can be very broad, and it's hard to diagnose the disorder based on the symptoms alone. The symptoms can mimic lymphoma, breast cancer, thyroid disease, neurologic disease, connective tissue diseases, autoimmune diseases, or other systemic diseases. Your doctor will hence try to rule these out first. 

To do this, any of the following tests might be ordered: 

  • Mammography 
  • Breast ultrasound 
  • Breast MRI 
  • Routine blood tests 
  • Inflammatory markers 
  • Auto-immune illness workup

If all your tests return negative and there's nothing to explain your obvious symptoms, then a diagnosis of breast implant illness can be suspected. 

Breast Implant Illness Treatment

Conservative Treatment

There's currently no known cure for breast implant illness; treatment focuses mainly on managing the symptoms. This includes: 

  • anti-inflammatory medication
  • pain management
  • sleep medications and therapy
  • hormone replacement therapy when needed
  • lifestyle changes such as stress reduction techniques and sports  

Breast Implant Removal 

If your symptoms fail to improve despite medical treatment, then breast implant removal might provide relief.

Concrete evidence is still lacking on whether explantation (removal of breast implants) is beneficial or not. According to a single small study, removing the implants was shown to benefit 89 out of 100 women who had self-reported BII symptoms. 

Should You Be Concerned? 

So, should you be worried about breast implant safety? Should you get your implants removed? Should you go and do any tests? Should you avoid getting implants altogether? 

There's currently no evidence to support the removal of breast implants to avoid BII. Over the past decades, breast implants have proven themselves as very safe medical devices. Long-term complications, such as BII, are very rare. 

If you don't have any symptoms, then you don't have to worry about BII or the safety of your implants. There's no need to do any tests. If you do have symptoms, then visiting an experienced plastic surgeon or GP will hopefully help you get a proper diagnosis and treatment. 

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About the Author:
Mersad is a medical doctor, author, and editor based in Germany. He's managed to publish several research papers early in his career. He is passionate about spreading medical knowledge. Thus, he spends a big portion of his time writing educational articles for everyone to learn.

Sources

  • [1] https://www.breastcancer.org/treatment/surgery/reconstruction/types/implants/special-report/breast-implant-illness 
  • [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882356/ 
  • [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294749/ 
  • [4] https://pubmed.ncbi.nlm.nih.gov/33634001/  
  • [5] https://pubmed.ncbi.nlm.nih.gov/32530850/ 
  • [6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7209857/
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