Patient Safety Advisory – Breast Implant Removal and Capsulectomy

This information was obtained from a Joint Safety Statement of the International Society of Aesthetic Plastic Surgery (ISAPS), The Aesthetic Society, and The Aesthetic Surgery Education and Research Foundation (ASERF).

Why are women requesting removal of their breast implants?

There has been a worldwide increase in the number of patients requesting implant removal for a variety of systemic symptoms that they attribute to their implants. This has been referred to as Silicone Incompatibility Syndrome (SIS), Autoimmune/Inflammatory Syndrome Induced by Adjuvants (ASIA), and Breast Implant Illness (BII). These include a variety of systemic symptoms such as joint pain, muscle aches, confusion, chronic fatigue, autoimmune diseases, and others

What implants cause Breast Implant Illness (BII)?

Systemic symptoms patients attribute to their breast implants have been reported with all types of implants: saline and gel filled, smooth and textured surfaces, and has been reported with implants from every manufacturer.

Does removal of implants alleviate the symptoms?

Some patients will experience symptom improvement with implant removal. The symptom improvement is independent of whether part or all the capsule was removed.

Is a capsulectomy necessary?

There is currently no good peer-reviewed evidence that capsulectomy is required for symptom improvement in the absence of other indications. Patient preference may be considered with appropriate informed consent. Capsulectomy is a more invasive procedure, may be more expensive, and may carry higher risks.

What should I do if I feel I have symptoms related to my breast implants?

Breast Implant Illness (BII) remain a diagnosis of exclusion so patients should have an appropriate medical evaluation to rule out other causes prior to surgery. Implant integrity should be evaluated with high-resolution ultrasound (HRUS) or MRI five years after implant placement and every 2–3 years after. If no other cause is found, it is likely that patients will see at least partial symptom improvement after implant removal. The symptom improvement may occur with no or partial capsulectomy which is a procedure that is less invasive, less expensive and may carry lower risk. Patients should seek out board-certified plastic surgeons for any concerns with their breast implants.