Breast Implant Illness: What Have We Learned So Far?

Breast Implant Illness: What Have We Learned So Far? featured image

In a latest viral TikTok, New York plastic surgeon Dr. Anthony Youn, MD described a mysterious sickness some sufferers say is attributable to their breast implants. Hair loss, joint ache, fatigue, rashes and muscle ache are just some of the signs described by sufferers who say they’ve breast implant sickness. With his TikTok video, Dr. Youn formally went on report to say BII is actual, a take that some plastic surgeons have discovered to be controversial.

“Breast implants can cause a constellation of symptoms in some women, called BII,” Dr. Youn says within the video. “Yes, I believe it’s REAL. But I also believe that most women do just fine with implants. But definitely not all.”

Similarly, Beverly Hills, CA plastic surgeon Cat Begovic, MD has additionally spoken publicly about BII: “A lot of you have asked me if Breast Implant Illness is a real thing,” Dr. Begovic shared on her social media channels. “Yes, it is very real and is devastating to the women who develop it. I personally have had three close friends who had it and I know how much they went through. Luckily none of my patients have developed it, but my friends’ experiences as well as the recent Allergan breast implant recall truly shook me.”

While these surgeons have gone on report publicly, not all plastic surgeons share the identical takeaway and are fast to level out that the jury nonetheless out on what’s inflicting these signs and whether or not or not explant surgical procedure helps to resolve these affected person issues. 

What Is BII?

First, it’s essential to notice that BII and the textured implant recall are two various things though they’re typically referred to in the identical breath. It was simply two years in the past that an FDA investigation breast Implant recall related to textured implants that precipitated breast implant-associated anaplastic giant cell lymphoma (BIA-ALCL), a uncommon type of non-Hodgkin’s lymphoma, in some sufferers. So now, two years after the recall and a subsequent American Society for Aesthetic Plastic Surgery (ASAPS) BII job pressure, the BIOCELL textured implants in query have been taken off the market and sufferers are repeatedly being educated on related dangers with these forms of implants if they’ve them and have been given the choice to swap them out for clean implants by the gadget producer if wanted.

“With regard to textured implants and breast implant illness, just to clarify those are two completely separate topics,” notes University Park, TX plastic surgeon William P. Adams, MD, a member of Breast Device Collaborative Community (BDCC), a company that offered the FDA with a beneficial affected person guidelines. “Textured implants as you know have had this association with a ALCL, but we also know that textured implants ALCR, but are rather a passenger in the development as they are carrier for bacteria that causes chronic inflammation that then can progress to ALCL.”

“Breast implant illness is not related to textured implants,” explains St. Louis, MO plastic surgeon Patricia McGuire, MD. “BII is not related to any specific type of implant, it occurs with saline, gel, smooth or textured. In an ongoing study where I am principal investigator, the majority of our BII patients have smooth saline implants.”

Learning More About BII

Dr. McGuire is likely one of the principal investigators in an Aesthetic Surgery Education and Research Foundation sponsored research trying additional into BII. “This is a prospective, blinded study where we are looking at capsules and peripheral blood on women with self-described BII as well as two control groups—women with implants who do not have systemic symptoms they attribute to their implants, and women who have never had an implanted medical device. We would like to see if there are any objective differences in the analysis of these specimens between the BII patients and control groups.”

In the research, surgeons are analyzing all of the theorized potentialities that may be triggering signs. “We are looking at next generation DNA sequencing for bacterial and fungal DNA on the capsules, as well as testing capsules for the presence of heavy metals,” says Dr. McGuire. “We are looking at cytokines, antibodies to bacterial toxins, inflammatory markers, thyroid function, and Vitamin D levels in all three cohorts.”

Eugene, OR plastic surgeon Mark Jewell, MD says latest analysis has proven a correlation between BII signs and COVID-19 “long haulers.” “More is to be learned here with regards to the future research on the overlap of Covid-19 ‘long haulers’ and BII,” explains Dr. Jewell. “The National Institute of Health (NIH) has committed to something like $1.15 billion Covid-19 research. As we move forward, we must discover what is true regarding medically unexplained symptoms of BII and similar disorders through evidence and reason towards conclusions that lead to a more accurate map of reality. Advocacy groups for these disorders appear entrenched in beliefs, resisting surrender to an opposing position regarding causation and treatment.”

Does Explant Surgery Help?

Many BII sufferers search explant surgical procedure to alleviate their signs, which at instances does assist, however not all the time says Los Angeles plastic surgeon Steven Teitelbaum, MD. “There is no data that shows long-term relief from explant surgery,” he says. “The problem is that people who blame their implants for almost every symptom they encounter makes it difficult to study. If you believe that everything that ails you is caused by your implants, there’s no way to do a study and control all the variables. However, there are people who clearly get better with explant surgery. But we have to ask, why do they get better? Are there other things they’re doing in their lives that also contribute them to improve. We have to study these things as well, we can’t just tell people to take their implants out and they will magically improve without knowing for sure what is making them sick and what is making them better.”

According to the Aesthetic Society’s procedural data from 2020, the number of explants surgeries being performed are on the rise,” says Dr. McGuire. “Personally, in 2019 I removed more implants than I placed. However, in 2020 I have seen a significant increase in the number of primary augmentations I’ve performed as well, so the trending numbers can be misleading. It’s important to note that not all explants surgeries are due to BII. We also have a lot of older patients taking their implants out due to body changes due to weight fluctuations as well.”

Whether or not explant surgical procedure will relieve BII signs continues to be not identified, however plastic surgeons who’re finding out BII signs say to be cautious of the surgeons who’re selling it as a cure-all repair. “This is a really important topic because there are some surgeons and patients that are very adamant that there needs to be a special type of capsulectomy performed, an en bloc capsulectomy,” provides Dr. Adams. “Patients are often times told by this a small number of surgeons promoting this procedure, but there is no science to say that this type of capsulectomy that is either needed or better.”

While no official analysis of breast implant sickness might be given by a health care provider at the moment, sufferers who’ve dominated out all different potentialities ought to seek the advice of with a board-certified plastic surgeon to get as a lot details about BII, it’s causes and potential options.

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