Breast implants and Breast Implant Associated Illness

Removal of breast implants is now one of the commonest operations performed by plastic surgeons.

The word is out that not only can certain types of textured breast implants cause a rare form of lymphatic cancer but also the silicone and other substances that leak from the implants can result in a number of symptoms broadly known as “Breast Implant Associated Illness”.  Several years ago our Chief Medical Officer advised that

“All silicone gel breast implants are considered high risk medical devices”.

This is because there are many other problems associated with breast implants such as capsular contracture, malposition, asymmetry, rippling, bottoming out, and even implant extrusion. All this is in addition to the complications above!

So, at the 6 week follow-up, following removal of their implants, I always ask my patients about their general health. Many women report significant improvement in their general health and sense of wellbeing.

A woman I saw this afternoon provides an interesting case in point. She originally had her implants inserted early in 2017. They were very large (460 cc) and she had an early complication of capsular contracture. This is when the breast feels very hard due to scar tissue forming around the implant. As a result, about a year after her implants were first inserted, she had them removed and replaced. As she said when I first met her:

“i should have been more informed and thought more about my choices”.

Two years following the first insertion of her implants her breasts still felt painful in her bra and she found it difficult to lie on her tummy. She found it painful to cuddle her children and felt that her muscle strength had been affected. She also felt that her energy level had decreased and she had noticed some hair loss in the temple area.

The procedure I performed was to remove her implants and to restore (at least partly) her breast volume by Autologous Fat Transfer.

At her 6 week follow-up she told me that her general health was much improved. Interestingly, she said that her energy levels had increased and that her hair loss had recovered! There was also the comfort of no longer having breast implants.

When I enquired further into her recovery of energy, she told me that her iron levels had dropped shortly after she had had her implants inserted. They had stayed low and only recovered once the implants had been removed. So the question for the researchers is – can the silicone cause a mal absorption of iron?

Replacing implants with your own fat is an obvious solution – especially if you have some excess fat available in hips and thighs. In fact many women appreciate the rebalancing of their figure that occurs when they lose fat from their hips and thighs and this is then transferred to their breasts. Even if the breasts are not as large as before, the breasts are a lot softer and more natural (both to the look and to the feel). The cleavage is especially improved by Fat Transfer and it is rare for a women to regret having her implants removed.

But what if more volume is desired?  Then it is always possible to do a secondary Fat Transfer.

Of course another option is to use smooth-walled saline implants. These are the safest of all implants, as they do not contain silicone gel and are therefore are not associated with Breast Implant Associated Illness. When placed behind the muscle, they often look and feel better than certain silicone gel-filled implants. A little more care and skill is required in their placement but for an experienced surgeon, when a breast implant is required, a smooth-walled saline implant is usually the best and safest option.