Breast implant illness (BII) is a term that some women and doctors use to refer to a wide range of symptoms that can develop after undergoing reconstruction or cosmetic augmentation with breast implants. It is also sometimes referred to as autoimmune/inflammatory syndrome induced by adjuvants (ASIA). BII can occur with any type of breast implant, including silicone gel-filled, saline-filled, smooth surface, textured surface, round, or teardrop-shaped.
BII impacts each individual in a unique way. Symptoms can include:
- Joint and muscle pain
- Chronic fatigue
- Memory and concentration problems
- Breathing problems
- Sleep disturbance
- Rashes and skin problems
- Dry mouth and dry eyes
- Hair loss
- Gastrointestinal problems
The symptoms can appear any time after implant surgery — some people develop symptoms immediately, while some develop them years later.
A lot of the symptoms of BII are associated with autoimmune and connective tissue disorders, such as lupus, rheumatoid arthritis, and scleroderma. Some people who have BII also get diagnosed with a specific autoimmune or connective tissue disorder, but many do not.
What causes breast implant illness?
Researchers don’t know why some women with breast implants develop BII. A leading theory, according to experts, is that some people are predisposed to having an immune reaction to the materials that are used to construct breast implants, creating inflammation that leads to symptoms listed above.
Studies have shown that substances from breast implants (such as very small amounts of silicone and platinum) can “bleed” through an intact shell and into the surrounding tissue. Substances from an implant can also spread within the capsule of scar tissue surrounding the implant or to other parts of the body, often because an implant has ruptured. The longer a breast implant is in place, the more likely it is to rupture. Some, but not all, people with BII turn out to have a ruptured implant.
All women with breast implants are exposed to silicone to some degree, because all implants have a silicone shell.
“It may be that the immune system is reacting to the silicone polymers that have been dispersed from the implant into the body,” says Lu-Jean Feng, M.D., a plastic surgeon and the founder and medical director of the Lu-Jean Feng Clinic in Pepper Pike, Ohio, who has been treating patients with BII since the early 1990s. “Certain people may be genetically predisposed to be more reactive.”
The History of Breast Implants
It’s worth taking a short look at the history of implants. As far as medical devices go, they’ve been around for a minute. Many women felt comfortable with the decision to get breast implants because they’ve simply been around for so long.
The first implants hit the market in the early 1960s as reconstructive prosthetics, in both silicone and saline varieties. Since then, multiple “generations” of breast implants have been released, with varying risks and safety concerns.
To this day, women are routinely warned before getting their implants of the risk of infection, painful hardening around the implant known as capsular contraction, or leakage or popping of the implant itself.
Back in the ’70s, the FDA actually ruled that a known-carcinogen was present in the chemicals of the implants, which could lead to breast cancer. However, this was not enough to discontinue that model or require physicians to explain that risk to their patients.
Silicone breast implants were banned by the FDA entirely in 1992, due to health concerns. Despite this, throughout the 2000s women continued to get implants in increasing numbers each year.
In 2006, the FDA lifted the ban of silicone implants under the agreement that they would conduct ongoing studies of women with silicone implants to keep an eye on their long-term safety.
However, in 2011 at a public meeting on breast implants, the FDA admitted that most of their test subjects had dropped out within just a few years. Many women testified that when they reported that their implants were causing health issues, they were dismissed from the study entirely.
Regardless of the sketchy-at-best science, silicone implants are still ruled as safe to this day.
Emerging research on breast implant illness
For the most part, the existing scientific literature doesn’t show a definite link between breast implants and autoimmune or connective tissue diseases and doesn’t show that that breast implants cause these conditions. A couple of recent studies suggest that silicone gel-filled breast implants are associated with a slightly higher risk of developing an autoimmune or connective tissue disease. One of the reasons these studies are notable is that each included a larger number of women tracked over a longer period than most previous studies on safety outcomes for women with breast implants.
- American Society for Aesthetic Plastic Surgery. Breast Implant Illness – Frequently Asked Questions/Talking Points. August 2019. Available at: https://www.surgery.org/sites/default/files/BreastImplantIllness_8-21-2019_FINAL.pdf
- Maijers MC et al. Women with silicone breast implants and unexplained systemic symptoms: a descriptive cohort study. Neth J Med. Dec. 2013: 71(10). Available at: http://www.njmonline.nl/getpdf.php?id=1392
- Coroneos CJ et al. US FDA Breast Implant Postapproval Studies: Long-term Outcomes in 99,993 Patients. Ann Surg. Jan. 2019; 269(1): 30–36. Available at: https://journals.lww.com/annalsofsurgery/Citation/2019/01000/US_FDA_Breast_Implant_Postapproval_Studies_.7.aspx
- Watad A et al. Silicone breast implants and the risk of autoimmune/rheumatic disorders: a real-world analysis. Int J Epidemiol. Dec. 2018: 47(6): 1846-1854. Available at: https://academic.oup.com/ije/article/47/6/1846/5133598