Why we need to talk about breast implant illness

What is breast implant illness?

"Breast implant illness (BII) is a non-medical term that has been used to describe a wide array of systemic symptoms experienced by some women who have breast implants," explains Marc Pacifico, president of the British Association of Aesthetic Plastic Surgeons (BAAPS).

You may not have heard of breast implant illness, and this is largely because it's not currently recognised as an official medical condition. However, as research seeks to fill in knowledge gaps, many experts believe that this could change.

The simple answer is that experts don't know why some women with breast implants experience these symptoms. This is why breast implant illness has eluded official medical status.

"The symptoms experienced by these women are very real, but we have no medical explanation for them, and their symptoms have not been scientifically linked to their implants," says Pacifico.

Clearly, there is much still to learn, and a huge amount of data is being analysed to establish if breast implant illness is a classifiable disease¹.

Pacifico highlights three recent high-level research studies:

1. One looked at whether the technique in which the breast implant capsule (surrounding scar tissue) was removed made a difference to the relief of their symptoms - the study found no difference between techniques².

2. Another investigated whether there were any underlying bacteria or other infections identified that might be contributing to their BII symptoms - there were no infectious causes identified³.

3. The last study sought to identify if heavy metal poisoning might explain symptoms - the only variations in heavy metal detection (that were all well below recommended levels) could be explained by being higher in women who had a breast augmentation and also had tattoos, were smokers, and had dietary habits that increased heavy metal intake. As such, there was no evidence of heavy metal poisoning⁴.

Is breast implant illness real?

It's important to remember that a lack of scientific evidence does not mean the symptoms experienced by many women are not real, and plastic surgeons should take all reports of pain, debilitation, and discomfort very seriously. Many diseases undergo a great deal of research before scientific explanations are found.

Do saline implants cause breast implant illness?

Some experts suspect that breast implant illness may be the body's inflammatory or autoimmune reaction to the silicone gel breast implants themselves. One thing we do know is that both saline-filled and silicone-filled implants can trigger symptoms.

Symptoms of breast implant illness can vary greatly and can have a hugely negative affect on a person's quality of life. Sometimes symptoms are so severe that women are left bed-bound for long periods, and there can be a huge emotional toll.

Symptoms can start soon after surgery or not for many years.

Without an identified medical explanation, healthcare professionals must rely on ruling out other health issues such as breast cancer first. Sadly, the lack of understanding around this illness often means that many people suffer without an explanation for their symptoms or are misdiagnosed with other conditions - including mental health problems.

Nonetheless, these symptoms can indicate a wide range of other medical issues⁵: "It is crucial that you see your GP to exclude other medical causes - these could range from medical diseases, other infections, menopausal reasons, or a host of other causes - that need to be excluded first," Pacifico advises.

If you're struggling with breast implant illness, there is hope for recovery. Many have found that removing their implants through surgery cures or significantly eases their symptoms.

However, this doesn't work for everyone, and every surgical procedure carries risks that need to be carefully considered and weighed up. If a scientific cause is found, this could unlock the key to better, more accurate treatment methods in the future.

Ongoing research is crucial, but for many women with breast implant illness, it's also important to speak up and raise awareness while this remains an unofficial condition.

Does everyone get breast implant illness?

While we have no data that tell us how many people develop breast implant illness, in recent years media coverage and social media groups are doing a lot to raise the profile of this issue. The UK government is also encouraging the public and healthcare professionals to report issues with implants, even if suspected, through the Yellow Card Scheme⁶.

The more information we collect, the better chance we have of improving care for those in need.

1. ABS, BAAPS and BAPRAS joint statement, Advice regarding breast implant safety.

2. Glicksman et al. Impact of capsulectomy type on post-explantation systemic symptom improvement: findings from the ASERF systemic symptoms in women-biospecimen analysis study: part 1.

3. McGuire et al. Microbes, histology, blood analysis, enterotoxins, and cytokines: findings from the ASERF systemic symptoms in women-biospecimen analysis study: part 3.

4. Wixstrom et al. Heavy metals in breast implant capsules and breast tissue: findings from the systemic symptoms in women-biospecimen analysis study: part 2.

5. BAAPS, Breast Implant Illness - what we know, and what we don't know.

6. GOV.UK, Symptoms sometimes referred to as Breast Implant Illness.