The Rise of Breast Implant Illness

Nearly 400,000 women in the United States undergo breast implant surgery each year. And as common as the surgery is, there are still risks. Breast implants may lead to fatigue, joint pain, headaches, or brain fog — symptoms classified as breast implant illness.

In 2022, Danica Patrick, a retired race car driver, posted on Instagram about her breast implant illness and why she decided to ultimately remove her breast implants. She detailed her hair loss, leaky gut, low estrogen, dry scalp and skin, weight gain, face swelling, and more. The comments underneath her post show that others are feeling the same. One user wrote, "I want my life back!" while another said, "It helps me to not feel crazy as we're told there's nothing wrong little lady so many times....thanks for being brave and honest."

Dr. Alan Gonzalez, M.D., says breast illness is on the rise.

The Columbian plastic surgeon with over 23 years of practice and more than 18,000 successful procedures is double-board certified by the American Society of Plastic Surgeons (ASPS) and the American College of Surgeons (ACS). "The possible symptoms associated with breast implants are seen more frequently every day in a significant number of patients, specifically in my practice," Gonzalez tells Healthnews. "As these symptoms have been studied and do not appear to be linked to any type of disease, there has been an increase in patients who refer or report symptoms associated with an immune response each month."

While the actual number of cases is unknown, doctors are reporting an uptick in symptoms.

<center> Dr. Alan Gonzalez </center>
Image courtesy of Dr. Alan Gonzalez

Each year, more and more people are seeking breast implants, a possible factor leading to the increase in breast implant illness cases, according to Gonzalez. This could also be due to an increase in women speaking out about their symptoms.

Gonzalez says there is a direct association between breast implants and symptomatology — the result of the immune system reacting to a foreign body agent.

Most individuals with breast implant illness have saline-filled or silicone-filled implants. Although the exact cause of breast implant illness is unknown, Gonzalez suspects those with autoimmune diseases are a group at increased risk for breast implant illness.

Common autoimmune diseases in women:

"Despite being a new situation in the scientific world, from my experience, I have observed that patients who have a family history of autoimmune diseases or who present associated autoimmune diseases are the group with the highest risk of presenting an increased immune response to foreign body and therefore the presence of possible symptoms associated with the implant once the implants are placed," Gonzalez explains.

What are the symptoms of breast implant illness?

Symptoms of breast implant illness affect the musculoskeletal system and central nervous system. Some people may begin feeling symptoms immediately after surgery, while others may notice symptoms years later. Gonzalez notes some may experience joint and muscular pains, while others may have headaches, memory complications, or lose their ability to focus. Other symptoms may include chronic fatigue, anxiety, depression, and panic attacks.

A small population study from the University of Utah School of Medicine surveyed 182 people a part of the Facebook group "Utah Breast Implant Illness." The most common symptoms associated with breast implant illness from the group included brain fog, fatigue, joint pain, and hair loss — perhaps due to anxiety. Gonzalez says the improvement of symptoms varies.

TikTok user, Danielle May, whose username is maewellness, highlighted her experience with breast implant illness by documenting her skin and eye concerns, which included dry and itchy eyes plus a rash and ringing in her ears. "My struggle has been real!" she wrote in the caption of her video.

@maewellness (BII) b reast implant illness. My struggle has been real! These impants are coming out in two weeks time. Tollow my journey of recovery. #breastimpantremoval #breastimplant #breastimplantillness #breastexplantation #breastimplantawareness #bii #implantillness #implantillnessawarness ♬ original sound - Danielle-May

"There is often an immediate improvement in some symptoms, but it is important to be aware that the final evaluation for most symptoms occurs 12 to 24 months after the explantation. According to our experience, a more or less rapid disappearance of the symptoms may be related to the time of exposure of the implant to the time when the symptoms appeared," explains Gonzalez. "The symptoms that remain in some patients after this time are the ones on which the medical analysis should be focused to determine what is causing them.”

After ten days of having her breast implants removed, Mae reported her improved appearance, skin, and mentality on TikTok in a video. She said, "my memory and mind feel extremely clear," and she explained that she feels a "thousand times better."

The hashtag, #breastimplantillness, has 227.8 million views, exemplifying the very real and very concerning side effects.

How do you treat breast implant illness?

In the Utah study, 40% of respondents had their breasts removed. Following removal, 97% reported relief of their symptoms. For breast implant illness treatment, Gonzalez lists the removal of the breast implant, and from his experience, a total capsulectomy are viable options.

A 2023 study found that removing the implant has incredible results in symptom severity. The research also found that people who have an autoimmune disease or have experience or anxiety or depression may have a predisposition to the illness. Therefore, a proper examination is crucial before going under surgery for breast implants.

"In addition, due to the secondary deformity that presents the realization of this type of surgery, we must think of performing immediate breast reconstruction so that the psychological affectation from the aesthetic result is not presented or diminished, then ideally the realization of the explantation with total capsulectomy and immediate breast reconstruction," Gonzalez says. "We do the BRALAN technique, which is a technique where the scar is L-shaped, and breast reconstruction emphasizes not only in the proper proportion of the breast but also in the reconstruction of the cleavage area of the breast."

For other plastic surgeons who are dealing with patients seeking breast implants, Gonzalez recommends that surgeons become educated on how the immune system reacts to a foreign object in the body. He says surgeons with this information will be able to warn patients of possible risks with implants. As for preventing breast implant illness, Gonzalez says surgeons should make implants a last resort unless the patient desires.

"It is essential that the surgeon has a thorough understanding of all possible techniques for breast surgery without implants in order to achieve the patient's expectations regarding breast shape without the need for implants, allowing the patient to have peace of mind knowing that there is no foreign body reaction," Gonzalez says. “Also, the surgeon should be familiar with the surgical options for increasing breast tissue by injecting fat from patients.”

In 2021, the U.S. Drug and Food Administration (FDA) strengthened breast implant safety by requiring surgeons to inform patients of the risks and potential possibility of breast implant illness. In order to make sure patients were aware of their decision and fully informed, the FDA approved labeling for breast implants, which included:

  • Boxed warning.
  • Decision checklist.
  • Silicone gel-filled breast implant rupture screening recommendations.
  • Patient device card.
  • Device description with a list of the materials.

Breast implant illness isn't the only complication with the cosmetic surgery, either. Other complications with breast implants include:

  • Breast pain.
  • Scar tissue that forms around the implant.
  • Rupture.
  • Connective tissue disease.
  • Breast cancer.
  • Effects on breastfeeding.

Due to the increase in these cases, Gonzalez notes his practice is providing more awareness around breast implants. Additionally, he highlights the need for patients to attend a consultation with their specialist to determine the possible association of the symptoms they suffer due to implants.

The big takeaway here is to stay informed. If you're seeking a cosmetic procedure, read up about it, do your research, and be aware of possible complications. And even more importantly, doctors need to communicate these complications and do their part. Their honesty and education can help save thousands of cases of the illness, which plagues a rising number of women.

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