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Breast Implant Illness: A 2022 Update from Board-Certified Plastic Surgeon Dr. Bob Basu

Breast Implant Illness (BII) Update from Houston plastic surgeon Dr. Bob Basu

Breast implant illness (BII) is a term used to cover a broad range of symptoms that are thought to potentially be associated with breast implants. There is little clear evidence about who develops BII and why, but research is currently underway to improve our understanding of these symptoms that have been reported by women with breast implants.

Breast implant safety

Modern breast implants are the most extensively tested, researched, and evaluated medical devices on the market. While all breast implants have a silicone outer shell, made from the same medical-grade silicone that is used in a variety of surgical procedures, you will have a choice between a saline fluid or silicone gel fill. The vast majority of our Houston breast augmentation patients choose highly cohesive silicone gel “gummy bear” breast implants; these most accurately mimic natural breast tissue in feel and weight.

In past decades, many women were frightened by reports that silicone implants posed a health risk and could lead to a range of serious diseases. While earlier generations of implants filled with non-cohesive silicone were more likely to rupture and leak, thereby causing complications, no studies performed on modern silicone implants have discovered a causal link between breast implants and systemic disease.

No studies performed on modern silicone implants have discovered a causal link between breast implants and systemic disease.

Modern silicone-filled breast implants were only reintroduced to the market after years of extensive, critical testing—and each earned a new FDA approval in the process. As such, they are considered safe for most breast augmentation patients.

Which breast implants are the safest?

Both saline and silicone breast implants are considered to be safe. Both types have silicone shells; the choice between the fill type is a personal one. The primary difference in the two types of implants is what happens in cases of a breast implant rupture. If a saline-filled breast implant ruptures, the sterile solution is safely absorbed by your body, and the breast implant visibly deflates—alerting you to the fact that your implant has ruptured.

If a silicone implant ruptures, the cohesive silicone gel remains within the breast implant pocket, and you may not realize that your implant has ruptured. (For this reason, the FDA recommends that patients with silicone implants undergo an ultrasound—or MRI if needed—screening after 5-6 years, with repeat screenings every 2-3 years after that.)

With any implant type, the solution for a rupture is to surgically replace your implant(s). While having revision surgery is an inconvenience, women who need breast implant replacement after rupture often use it as an opportunity to update their implant size and/or type.

Complications from breast implants

The most common breast implant complications that may require revision surgery are the following:

  • Capsular contracture
  • Rippling
  • Malpositioned implants
  • Asymmetry

The above complications can happen with any implant, though rippling is more common with saline-filled implants.

Other complications that have been associated with breast implants include surgical complications such as bleeding, bruising, or swelling. As discussed above, there is also the possibility of deflation or rupture.

With highly-textured shell implants, there has been a proven, though rare, association with breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), leading certain implants to be removed from the market. The symptoms for BIA-ALCL can include a delayed seroma (where one breast increases in size without explanation many years after surgery) or a mass. Fortunately, with early detection, it can be cured with implant and capsule removal.

Lastly, there may also be a potential risk of breast implant illness (BII) with breast implants.

What is breast implant illness (BII)?

“Breast implant illness” is an umbrella term for a range of systemic symptoms that are thought to be associated with breast implants, including:

  • Joint pain
  • Muscle aches
  • Chronic fatigue
  • Confusion
  • Autoimmune disease
  • Skin rashes or problems
  • Headaches
  • Hair loss

Note that there are no clear diagnostic criteria for breast implant illness, and locating the source of your symptoms will require a process of elimination to check for other underlying health conditions that resemble BII. A proper medical workup for these symptoms should be completed before implant removal.

“Breast implant illness” is an umbrella term for a range of systemic symptoms that are thought to be associated with breast implants.

What symptoms of breast implant illness or implant complications that I should be alert for?

If you feel that something is not right with your implants or you are experiencing unusual symptoms, you should make an appointment to see your original plastic surgeon. Some abnormal symptoms to be aware of include:

  • Unusual scarring or lumps in the breast, such as hardened areas below the skin
  • Excessive fluid collecting around the implants
  • Swelling of the breasts long after healing has concluded
  • Any color change to the breast tissue
  • Discharge from the nipples
  • Noticeable asymmetry, i.e. one breast becoming noticeably larger or misshapen

How do I reduce my risk of breast implant illness?

While there is no known method for preventing breast implant illness, selecting a board-certified plastic surgeon who is a breast surgery specialist will go a long way toward preventing other complications and ensuring that every step of your surgical procedure is performed with the utmost cleanliness and safety. It also means that your plastic surgeon will be there for you if you have any questions or symptoms after surgery.

Look for a plastic surgeon with:

  • Board certification in plastic surgery
  • A reputation for excellence
  • A focus on patient health and safety
  • Breast surgery expertise

Breast augmentation is a safe and effective procedure when performed correctly, under sanitary and hygienic conditions. These surgeries have been performed with great success for many decades, but not all breast plastic surgeons are equal in skill, artistry, and the use of advanced surgical techniques.

Does breast implant illness go away after breast implant removal?

Not always. Some women find that their BII symptoms improve after removing their breast implants, while other patients find their symptoms do not resolve, and their health issues and diagnosis remain unclear. In most surgeons’ experience, 50% percent of BII patients feel better after implant removal and 50% do not feel better. More research is needed and currently being performed on this issue. That said, breast implant removal patients can derive peace of mind from eliminating the possibility of breast implants contributing to their symptoms.

In most surgeons’ experience, 50% percent of BII patients feel better after implant removal and 50% do not feel better.

What are the options for breast implant removal surgery?

The goal of breast implant removal surgery is to restore a natural-looking chest contour and meet a patient’s personal goals for their body. Depending on your goals and whether or not you are experiencing a complication, Dr. Basu will educate you on all of your options and work with you to create a completely customized treatment plan to give you peace of mind and a natural-looking result. He may recommend a partial capsulectomy, total capsulectomy, or—in rare cases—an en bloc capsulectomy.

Further, to add a very conservative amount of extra volume to the breasts in the same procedure, Dr. Basu may perform a fat transfer breast augmentation. And for patients who have had their implants for a long time, a breast lift is often utilized to reshape natural breast tissue, remove excess skin, and situate the breasts higher on the chest wall.

In this episode of the plastic surgery podcast Behind the Double Doors, Dr. Bob Basu discusses why patients seek breast implant revision or replacement, what the procedure entails, and what to know before your consultation.

About Houston board-certified plastic surgeon Dr. Bob Basu

Dr. Bob Basu is a breast surgery expert and co-editor of the textbook Cosmetic Breast Surgery. Patient safety is paramount at Dr. Basu’s state-of-the-art clinic, Basu Aesthetics + Plastic Surgery, an Allergan Black Diamond provider for breast implants in the top 1-2% of providers in the country based on surgical volume. Our private, on-site surgery center in Cypress, TX meets the highest level of hospital-grade safety and quality, exceeds the requirements of most accredited surgery centers, and is fully licensed and accredited. Dr. Basu hand-selected our professional staff of nurses, board-certified anesthesiologists, and other aesthetic professionals.

Whether you are dealing with a complication or are concerned about breast implant safety, Dr. Basu is here to help you understand medical nuances and put your mind at ease with an appropriate treatment plan. To schedule your consultation at one of our Post Oak Houston or Cypress locations, call 713.799.2278 or contact us online.

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