Silicone breast implants have been used for over 60 years and have been highly satisfactory for the majority of women. However, a small subset of patients have reported a collection of symptoms thought to be related to their implants. This collection of symptoms have been termed breast implant illness.
The symptoms reported have ranged from brain fog and memory loss to autoimmune diseases, including rheumatoid arthritis and scleroderma. The mechanism by which implants cause illness in some women has not been elucidated. The most accepted explanation is that silicone acts as an antigen, stimulating the immune system, and causing inflammation in different organ systems leading to the symptoms described.
Multiple studies have been done to verify if there is a correlation between these symptoms and breast implants. To date, multiple retrospective and prospective studies have shown no correlation between breast implants and autoimmune diseases. One study by Coroneous, et al, reported a higher rate of some specific autoimmune illnesses in patients with implants but this study was plagued with limitations including loss to follow up and reporting irregularities. Such limitations have plagued the study of this illness and for this reason more studies are needed.
Despite the fact that multiple studies have not supported a correlation between breast implants and disease, including connective tissue disorders, some women report improvement in their symptoms following explantation. For this reason, plastic surgeons treating this condition should not disregard this as unsubstantiated.
- At the present state, there is overwhelming evidence to support the safety of silicone breast implants
- Ultimately, the decision to obtain, keep, or remove breast implants is up to the patient
- If a patient chooses to have her breast implants removed, it is important to find a board-certified plastic surgeon with expertise in breast surgery
- If a patient chooses to have implants removed, she should consider having the entire capsule removed, unless the posterior capsule is adherent to the chest wall, which may increase surgical risk.
- In cases of Bi-ALCL or ruptured implants with thick calcified capsule, a total capsulectomy is mandated.
Breast Implant Illness: A Way Forward. Magnusson, Mark R. MBBS, FRACS; Cooter, Rod D. MBBS, PhD, FRACS; Rakhorst, Hinne MD; McGuire, Patricia A. MD; Adams, William P. Jr MD; Deva, Anand K. BSc(Med), MBBS, MS, FRACS. Plastic and Reconstructive Surgery: March 2019 – Volume 143 – Issue 3S – p 74S-81S
Silicone Implant Illness: Science versus Myth? Rohrich, Rod J. M.D.; Kaplan, Jordan M.D.; Dayan, Erez M.D. Plastic and Reconstructive Surgery: July 2019 – Volume 144 – Issue 1 – p 98-109
Discussion: Silicone Implant Illness: Science versus Myth? Colwell, Amy S. M.D.; Mehrara, Babak M.D. Plastic and Reconstructive Surgery: July 2019 – Volume 144 – Issue 1 – p 112-113