Breast Implant Illness – Is It Real?

BREAST IMPLANT ILLNESS ( BII )

Breast implant illness has again become a controversy within the media and the public. Concern about BII has existed since the eighty’s with no real ability to diagnose it, or causally prove its existence. There has been no real progress in understanding BII or whether it is a real entity.

Breast Implants have been used for cosmetic augmentation and cancer reconstruction for decades. Most patients have done very well with few problems.

A few patients whom have undergone these procedures, have developed, at some time following, a wide variety of vague symptoms ( headache,fatigue ,muscle pain,dental problems,hair loss ) or symptoms  compatible with autoimmune syndromes or collagen vascular diseases.

Some patients have argued that they were healthy prior to the introduction of breast implants and the only thing to change in their life was the use of breast implants. There is a certain easy logic to this argument, but very poor science to be able to show or prove a causal relationship.

IS BREAST IMPLANT ILLNESS REAL?

The simple answer answer is, we don’t know.

There is no test that can be done to show a patient has this “illness”.

Population studies have shown that the incidence of collagen vascular/autoimmune diseases is the same in implant and non-implant patients (seeming to show implants are not a contributing factor).

WHAT DO WE KNOW?

Everyone has some silicone in them.

Breast implants, like all implants, get encapsulated in scar tissue.  In a small group of patients this scar will tighten causing capsular contraction. When implants (foreign body) are removed the capsule will be resolved by the body.

Very few patients with textured breast implants maybe at risk of developing ALCL.

With aging, people develop a variety of somewhat vague symptoms and sometimes specific diseases. 

Patients who experience “breast implant illness” have symptoms that they feel are real. To date, it is not possible to prove that breast implants are related to these symptoms . There is no test to connect the two.

Patients who undergo explanation with or without capsulectomy may not experience any long term change in their symptomatology.

In summary, patients with the symptoms of BII may have real issues but they will most likely be found to be multifactorial and Not directly related to breast implants.

If you have concerns re Breast Implant illness, you should seek information from your Plastic surgeon , or any Plastic Surgeon(FRCSC). Banff Plastic Surgery also has great resources if you’d like to learn more.

Breast Implants – What is BIA-ALCL?

Do You Have Breast Implants?
Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare sub-type of T-cell non-Hodgkin lymphoma (NHL)that has been found in association with breast implants in a small number of cases world-wide, with 22 confirmed confirmed cases in Canada.

Causes and Theories
The cause is unknown as of now, but it can be treatable with complete removal of the capsule and implant if caught early enough.

One of the most plausible current theories on causation of BIA-ALCL is that it is related to the biofilm. A biofilm is where bacteria are attached to an implant surface and surrounded by a protective layer of glycoprotein. They are difficult to treat, but there is no substantial evidence this is in-fact the cause.

Data regarding the frequency of occurrence of BIA-ALCL has been changing as more research is being done.

Textured implants have been shown to significantly increase risk of BIA-ALCL, the implant fill (saline or silicone ) does not appear to be associated with BIA-ALCL.

Two Common Symptoms
1. Swollen breast caused by the formation of a delayed (>1 year since implant placement,)
2. Unilateral idiopathic seroma occurring between the implant surface and the capsule.

Our Patients
For any patients of Dr. K Murray and Dr. G B Singh, at both Plastic Surgery Associates and Western Surgery Centre, please be reassured that we have used very few textured implants over the years, and your risk is minimal.

If you have any questions about breast implants, whether for augmentation or reconstruction, please make an appointment to discuss your particular situation.

We are happy to discuss this issue with any patient who has questions or concerns regarding their implants.