Dr. Kirby's Blog
Should I Be Worried About Breast Implant Illness?June 21, 2019 by Dr. Kirby
Breast implants have been in the media more than usual lately. You may have heard news features on women who had their implants removed after experiencing symptoms such as fatigue, joint pain, and brain fog. These and other symptoms, which vary from patient to patient, have been called breast implant illness (BII).
There is still a lot to learn about BII—so much so that it has not yet been defined as a specific disease by the medical establishment. To date, no specific tests exist that can diagnose it. Even so, as a board certified plastic surgeon who performs many breast augmentation and reconstruction procedures each year, I am concerned and believe it is important to listen to all patient concerns about breast implant safety.
If you have breast implants and feel fine now, it is reasonable to believe you will continue to be among the majority of patients who live healthy, full lives with implants. On the other hand, if you have symptoms similar to women reporting BII, see your primary doctor and plastic surgeon.
I want to make sure that my patients have access to reliable information from board certified physicians as well as from patients who have experienced breast implant illness personally.
If you are concerned about breast implant illness, I encourage you to watch the following video from the Plastic Surgery Channel. You will likely feel more educated and less worried after hearing from these women, including two patients who have undergone breast implant removal after experiencing BII symptoms, two board certified plastic surgeons, and one board certified family medicine physician.
I applaud these patients and plastic surgeons for taking the time to hold a frank, thorough, and constructive conversation about breast implant illness, the difference between BII and another condition called BIA-ALCL (which I will discuss in a future post), and how patients and plastic surgeons can approach the issue together.
Key takeaways from the breast implant illness video
I have highlighted and expanded on some of the main points below.
Breast implant illness is rare and should not cause concern in women who have implants and feel fine
Currently, an estimated 50 million women worldwide have breast implants and about 300,000 women choose to have breast augmentation each year in the United States alone. Most do not develop any concerning symptoms. If you have breast implants and are doing well now, it is likely that you will be among the vast majority of patients who continue to enjoy their implants for many years.
On the other hand, if you have breast implants and have developed symptoms you think may be connected with your implants, make appointments with your primary care physician and your plastic surgeon for follow-up.
Currently, there is no way to test for or diagnose breast implant illness—we can only rule out other conditions.
The only way to know if a patient’s symptoms are related to breast implants is to remove the implants and see if the symptoms resolve. Sometimes they do, and sometimes they do not. We cannot predict who will experience relief from breast implant removal and who will not.
With this in mind, I encourage patients who are worried about breast implant illness to visit with both their plastic surgeon and their primary care physician to rule out other possible issues, as many breast implant illness symptoms are shared with other conditions. If another underlying cause is found with tests, it will help direct you to the most appropriate medical treatment and avoid unnecessary surgery.
If you have a good rapport with your original plastic surgeon and they support BII patients (as I do), it’s a good idea to see them instead of a different surgeon, as they will be most familiar with details of your implant placement and anatomy.
If you would still like your implants removed anyway, then it is time to discuss surgery with your plastic surgeon.
Online support groups are important, but so is a visit to your plastic surgeon
Online support groups can be an important resource and help patients feel understood and get emotional support from other women living with symptoms. Meeting in person with your primary care physician and a board certified plastic surgeon is the next key step to determining what course of action is best for you.
It is important to remember that people contributing to online forums are speaking about their personal experiences, and what worked for them may not apply to you.
Based on your priorities, your medical test results, your feelings about your implants, and your personal anatomy, your doctors will develop your unique treatment plan.
If you have a good rapport with your original plastic surgeon and they support BII patients (as I do), it’s a good idea to see them instead of a different surgeon, as they will be most familiar with details of your implant placement and anatomy. It also helps the surgeon get a clearer picture of how many of their own patients are affected by BII.
If you have any hesitation about seeing your original surgeon, seek a different plastic surgeon who is board certified by the American Board of Plastic Surgery and has experience performing breast implant removal and revision procedures.
When you meet with your plastic surgeon, you can discuss:
- How long you’ve had your implants
- When you started noticing problems
- What symptoms you currently have and how they are affecting your life
- What medical tests, if any, you have had to date
- What to expect with breast implant removal surgery and recovery
- How you would feel if symptoms do not resolve after removing implants
- Costs and financing options for explantation
If you are not experiencing any symptoms, but are concerned about the possibility of breast implant illness, it may help to visit with your plastic surgeon and ask questions. (I’m always happy to see my patients.)
There are multiple options for safe breast implant removal
If you are considering breast implant removal, choose a plastic surgeon based on training, experience, and reputation, as well as your comfort level with them—not based solely on whether they perform a specific technique. What you want instead is a surgeon who is very experienced with a full range of implant removal techniques, so they can do what is best for you when it comes time for your surgery.
In many online forums, social media groups, and websites devoted to breast implant illness, patients are urging all women to insist upon the en bloc capsulectomy technique for breast implant removal. “En bloc” means removing the breast implant with the surrounding scar tissue capsule as one piece, without opening the capsule.
En bloc capsulectomy is not the only way to completely remove the implant and capsule. In some cases, a total capsulectomy—which removes the implant first and then the capsule—may be a safer way to remove implants and tissue that has been in contact with them.
While it is true that en bloc capsulectomy may be the best option in certain cases, the en bloc technique is a complex procedure that comes with its own unique serious risks. It requires a much longer incision and more scarring than other explantation methods. This method also increases the risk of damaging surrounding tissues including your lungs and ribs. In thin patients, the risk of pneumothorax, or lung collapse, is higher, simply from attempting to remove the breast implant capsule in one piece.
En bloc removal is not the only way a surgeon can remove the implant and capsule. In some cases, a total capsulectomy—which removes the implant first and then the capsule—may be a safer, less traumatic way to remove implants and tissue that has been in contact with them.
Do not dismiss a plastic surgeon who tells you that an en bloc capsulectomy may not be possible or is not the best option for you. No surgeon can promise en bloc removal beforehand. They are looking out for your safety and being honest about what is realistic given your specific anatomy. Rather, beware the surgeon who promises a particular technique before your surgery. If a surgeon seems dismissive of your concerns, it may be time for a second opinion.
Have more breast implant safety questions?
If you have questions or concerns about breast implants, or are considering breast augmentation or breast implant removal in Fort Worth and wish to know the facts, I invite you to contact me to schedule a personal consultation. I will do my best to answer all of your questions and provide you with the information you need to make safe, sound decisions for yourself.