I was at a plastic surgery conference several years ago, in the audience, when the panel of “experts” began discussing breast implant illness. At that time, there was a lot of emerging evidence of a negative immune response to breast implants in certain patients. There was also an emerging online society of women who had had this experience, had been dismissed by their physicians, and had been struggling and suffering for years with the problem.
Someone in the audience asked one of the experts how he defined breast implant illness, and he said, “Breast implant illness is what you get when you mix a tired woman with breast implants and social media.” Ok then.
One of the biggest problems with BII is that, while there have been patients with this condition for many years, it has taken a very long time for the condition to be validated. To date, there is still no blood or imaging test that can confirm or deny that someone has the condition. There is also no clear evidence of a genetic status that would make someone more likely to get it, therefore no way to screen patients for being high risk. The signs and symptoms of the condition are also very varied and non-specific: fatigue, digestive problems, skin and hair changes, memory loss, etc… It is easy to think that you are just tired or stressed and need a vacation.
In my many years treating women with BII, I have found a few things to be incontrovertibly true.
- Women know their bodies, and they know when something is wrong with them.
- Just because we do not have a test for a condition does not mean that it does not exist.
- Most patients with BII will get better once their implants are removed.
- Most patients who get breast implants do not experience BII, and have an extremely high satisfaction rate from the procedure.
Because there is no test for BII, it is difficult to know exactly how many patients suffer from it. BII also exists on a spectrum, with some patients having mild symptoms and others being unable to get out of bed. Awareness and preparedness are the key to this condition, and having a surgeon who is knowledgeable and validating is essential. A few years ago, I read about a surgeon who had decided to stop implant breast implants altogether because of the emerging information about BII. I thought about this at length, especially since my moral and ethical code prevent me from ever performing any procedure that I believe would harm someone. But, given the low incidence of the problem (none of my own patients have ever developed this issue to my knowledge), and the incredibly high satisfaction rate with the procedure for almost everyone else (with most patients telling me that it was life changing for them), I have come to the conclusion that it would not make sense to exclude making so many people from being so happy for this reason alone. I have also always been committed to sharing whatever information I have with my prospective and current patients, and they know that they can come to me with any concerns and that they will be addressed. The bottom line is that, as with anything in life, even truly wonderful things have a small risk of going wrong; but the odds are still strongly in your favor that they won’t.
