What Is Breast Implant Illness (BII)?

Breast implant illness (BII) is a group of symptoms that can occur after implant insertion. Though this terminology applies to this group of symptoms, it is not an official medical diagnosis. Symptoms of breast implant illness include fatigue, brain fog, joint pain, and more. BII symptoms can affect anyone regardless of implant type or length of time since insertion. 

This article reviews the symptoms, causes, diagnosis, treatment, and prognosis of breast implant illness. 

Types of Breast Implant Illness

The U.S. Food and Drug Administration (FDA) has medical device reports (MDRs) for all types of implants regardless of their surface, filling, or shape. This means breast implant illness may affect those with silicone, saline, smooth, and textured implants.

You may also hear people refer to breast implant illness by one of the following terms:

• BII
• Generalized/unexplained illness
• Unexplained systemic symptoms
• Breast implant disease
• Silicone implant illness
• Autoimmune/autoinflammatory syndrome induced by adjuvants (ASIA)

How Common Is Breast Implant Illness (BII)?

According to the FDA, determining the rate of breast implant illness is difficult due to information gaps in the medical device reports (MDRs). Gaps include underreporting, duplicates, and missing information. Also, the MDR alone doesn’t confirm that the device is the cause of the symptoms. 

The following are the results the FDA did gain from these MDRs:

• Age-related data was available in 56% (4,196 of the 7,467) of the MDRs.
• The average age of symptom onset was around 42 years old.
• The age range of symptom onset was 9–88 years old (some were for children born to women with breast implants).
• The time frame from implant surgery to symptom onset was available for 78% (5,798/7,467) of the MDRs.
• Symptom onset ranges from 0–42.5 years after breast implant insertion.
• The average time from implant insertion to the onset of symptoms was 5.1 years.

Breast Implant Illness Signs and Symptoms

Breast implant illness symptoms can range in severity. The signs of BII can occur soon after insertion or many years later. 

Common Symptoms

The most common signs and symptoms of BII are:

• Breast pain
• Fatigue (extreme tiredness not resolved with rest)
• Brain fog (problems concentrating)
• Joint pain or swelling
• Muscle pain
• Skin rash
• Eye or vision problems
• Memory loss
• Symptoms or diagnosis of an autoimmune disease

Possible Symptoms

Though this is not an exhaustive list, other symptoms of breast implant illness may include:

• Depression
• Panic attacks
• Anxiety  
• Hair loss 
• Dizziness
• Headache
• Dry skin, hair, and eyes
• Stomach problems

It’s important to note that the term breast implant illness is relatively new, and research is sparse. The FDA states that it is difficult to use medical device reports to confirm that the symptoms are from breast implants and not something else.

What Causes Breast Implant Illness?

The cause of breast implant illness is still unknown. Researchers are determining the degree of certainty that the symptoms are due to breast implants. 

An autoimmune reaction from the following may cause breast implant illness symptoms:

• The implant itself
• Pieces of the implant
• Leaking silicone 
• Chemical exposure
• Bacteria or other contaminants (biofilm contamination)

The medical community does not widely accept that silicone in medical devices affects the immune system. The FDA and researchers note this topic needs further investigation.

What Is the Treatment for Breast Implant Illness?

Treatment for breast implant illness often involves removing the breast implants and a capsulectomy (removing scar tissue around implants).

If you are considering breast implant removal due to BII symptoms, seek the counsel of a board-certified plastic surgeon with experience in BII and explantation.

What Is Explantation?

Plastic surgeons call the removal of breast implants an explantation. An explanation may also involve removing or releasing the scar tissue surrounding the implant (capsule). 

The following are various types of explantations:

• En bloc explantation: The plastic surgeon removes the implant and scar tissue as one unit.
• Explant with total capsulectomy: The plastic surgeon removes the implants and then the scar tissue (capsule). The advantage of a total capsulectomy is that it prevents substances within the capsule from escaping into the body. It also decreases the risk of a seroma (fluid buildup). 
• Explant with partial capsulectomy: The surgeon removes the implant and a portion of the scar tissue.
• Open capsulotomy: The surgeon removes the scar tissue, but the capsule remains in the patient.
  

Most surgeons don’t recommend getting implants again after breast implant illness. Discussing alternative reconstruction options with your plastic surgeon before surgery is also essential. 

When implant removal is complete, the plastic surgeon may rinse the area with an antibiotic solution to help remove any present bacteria. They will also send the tissue to the lab to evaluate for bacteria and rule out breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).

Additional treatment may involve medications such as:

• Anti-inflammatories
• Antibiotics
• Antifungals

Prognosis

Most women report that symptoms of breast implant illness go away shortly after implant removal. Though some women find their symptoms remain, most eventually experience relief within three to six months after breast implant removal. 

Results from one research study shows:

• All participants with bacterial contaminants report improvement after implant removal.
• No cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) among those with BII and implant removal.
• A capsulectomy, in addition to implant removal, is more effective than a removal alone.

Coping With Breast Implant Illness

Coping mechanisms are different for everyone. The Centers for Disease Control and Prevention (CDC) offers its How Right Now tool to help you identify your feelings. It provides suggestions for coping mechanisms to guide you. 

Problem-Focused Coping Mechanisms

If breast implant illness is causing fatigue or brain fog, you may want to consider problem-focused coping mechanisms. This may involve:

• Asking for help or support
• Establishing healthy boundaries (learn to say no to things you don’t want to do or don’t have time to do)
• Creating to-do lists or using other organizational tools

Emotional and Mental Coping Mechanisms

If you struggle with stress, self-esteem issues, depression, and anxiety, the following emotional coping mechanisms may be helpful.

• Make time for self-care (spiritual, mental, emotional, and physical)
• Get creative or find a fun hobby
• Practice stress reduction and relaxation techniques
• Spend time in nature
• Reach out to friends or family
• Reach out to someone in your faith community
• Talk therapy

You can also connect with support groups or breast implant illness communities such as Healing: Breast Implant Illness. It can help to discuss challenges with others who face the same, so you don't as feel alone. 

Healthy Lifestyle

The following are common lifestyle changes that can help you cope and boost your overall health and wellness.

• Eat a balanced diet 
• Exercise regularly
• Stay hydrated (drink more water, avoid alcohol and caffeine)
• Get at least seven to eight hours of sleep each night

Summary 

Breast implant illness (BII) is a group of physical symptoms that can occur for those with breast implants. Symptoms may begin right after implant insertion or many years later. Some of the most common symptoms are fatigue, joint pain, brain fog, anxiety, and hair loss. 

There is no definitive cause of BII, but researchers speculate it could be due to an autoimmune reaction and bacterial contaminants. Treatment typically involves medication or removing the breast implants and any scar tissue (capsulectomy). Most (though not all) symptoms resolve within six months of breast implant removal.