Breast Implant Illness – What should I do?

Breast Implant Illness refers to illness such as fatigue, brain fog, muscle aches and pains, skin rashes, hair loss etc. in women who have breast implants. It is seen most commonly in those who have textured silicone implants.  The courser the texture, the more likely and severe the symptoms.  Research suggests that the illness is due to inflammation caused by the implants and that it is cured by removing the implants.

A recent study showed that inflammation of the capsule around the implants occurred more often with silicone compared to saline implants and with textured compared to smooth implants. It is therefore extremely rare to occur in women with smooth-walled saline implants and most likely to occur in patients with textured silicone implants.

If left untreated, over a period of 10 years or more, the chronic inflammation can lead to a condition known as ALCL or Anaplastic Large Cell Lymphoma. This is a type of cancer that forms in the capsule surrounding the breast implants. If you have the symptoms of Breast Implant Illness or have textured silicone implants and would like them removed to reduce your risk of developing ALCL, then the question inevitably arises about what to do with the capsule around the breast implants.

There are strong opinions expressed on social media that “all of the capsule must be removed”. Yet this advice is incorrect and can be extremely dangerous for many women. 

The reason is that in recent years, many implants have been placed behind the pectoral muscles.  In this situation the capsule that forms is usually adherent to the rib cage as well as to overlying muscle. Attempting to remove all of the capsule can easily result in haematomas (blood clots) pneumothorax (collapse of the lung) severe distortion and scarring of the breast as well as complications such as deep vein thromboses.

Understanding that it is the textured implant that is the cause of the inflammation and that removing the implant results in the inflammation disappearing followed by the symptoms of Breast Implant Illness means that asking for a total capsulectomy will add significant risk to your procedure without any significant benefit.

In some situations doing a total capsulectomy is relatively safe and straightforward. This is when the implant is situated on top of the muscle, especially when it is very old and the capsule is calcified forming a clear demarcation between the capsule and the surrounding tissue. It is these capsules that are photographed and appear on social media. However, even in this situation, a total capsulectomy can result in significant distortion and scarring of the breasts.

So rest assured, the evidence clearly shows that removing your breast implants will prevent the inflammation of the capsule and cure Breast Implant Illness. 

Another consideration is how to reconstruct your breasts following removal of the implants. This is because, especially with larger breast implants, the breast skin has stretched so much that not only will the breasts have a smaller volume but they will also sag.

It is reassuring to know that smooth-walled saline implants do not cause the same degree of inflammation and so are not associated with Breast Implant Illness.  So therefore a direct swap of your implants for smooth-walled saline implants may be the best solution.

If you prefer to avoid implants entirely, then Autologous Fat Transfer is available as an alternative to breast implants. Sometimes this is combined with a breast lift in order to restore breast shape and maximise your breast volume.

At Avenue Aesthetic Surgery, we have many years’ experience of helping women with Breast Implant Illness. Our go to operation is to remove the implants and reconstruct the breasts by Autologous Fat Transfer adding a breast lift (or mastopexy) when required.