Breast Implant Removals Rarely Involve Complaints About Symptoms of Breast Implant Illness: Study

Capsular contraction and implant ruptures are far more common causes for complications and surgical revisions than breast implant illness, researchers reported

In recent years, a number of women have reported experiencing an array of side effects commonly referred to as breast implant illness (BII), including fatigue, cognitive problems, pain and other health issues. However, the findings of new research suggests that the vaguely defined syndrome only accounts for a small portion of the reasons women get their breast implants removed.

In a study published in the medical journal JAMA Network Open on October 7, researchers from The Netherlands found that problems with local postoperative complications are a far more common reason for breast implant removal than breast implant illness (BII).

Breast Implant Illness

In recent years, the medical community has come to recognize a host of symptoms that have been linked to silicone breast implants, causing women to experience fatigue, brain fog, memory issues, muscle and joint pain, hair loss, infections, gastrointestinal problems, rashes and thyroid issues.

In August 2020, the FDA announced that it received 2,497 reports consistent with symptoms of Breast Implant Illness between November 2018 to October 2019. Before that, between January 2008 and October 2018, the agency only identified 1,080 such reports.

“Although the impact of BII is becoming more apparent, the definition of BII, as well as its existence and prevalence remain unclear,” the researchers reported in this latest study. “A clear need exists among patients, medical specialists, legislators, and the industry, not only for a validated diagnosis, but also for scientific evidence on the causes and prevalence of BII.”

To determine how big a role breast implant illness plays in women’s decisions to get their implants removed, researchers conducted a legacy cohort study on breast implant revision surgery from April 1, 2015, to December 31, 2020, as well as a prospective cohort study on breast implantation and revision conducted from April 1, 2015, to December 31, 2019, with follow-up until December 31, 2020. They used data from the Dutch Breast Implant Registry.

According to the findings, breast implant illness was listed as the reason for 4.7% of cosmetic revisions and 0.7% of reconstructive revisions in the legacy cohort study, and for 4.2% of cosmetic revisions and 2.7% of reconstructive revisions in the prospective study.

By comparison, in both cohorts, the most common reason for breast implant revision was capsular contracture, which made up 37.1% of overall cosmetic revisions and 37.9% of all reconstruction revisions. The next most common reason for revisions was implant ruptures, which were responsible for 22.5% of cosmetic revisions and 24.2% of all reconstructive revisions.

“In this cohort study of women with silicone breast implants, despite increasing public interest in BII, it was an uncommon indication for revision compared with local complications, in both the short and long term,” the researchers concluded. “The provided preliminary associative data could ultimately be used to estimate which implant recipients are most likely to develop BII. Despite the low risk of BII, the main concern is who BII actually affects. Large cohort studies are strongly recommended to investigate the prevalence of BII symptoms before and after implantation together with risk factors related to BII”

Other Breast Implant Health Risks

Estimates suggest that between one million and three million women in the United States have received breast implants, with about 60% of the procedures done for cosmetic reasons, since the implants are generally believed to be safe and carry few, if any, serious side effects.

In recent years concerns have emerged about a rare breast implant cancer risk, known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), which can develop in the tissue surrounding certain types of implants, primarily with textured surface areas.

Last month, the FDA issued a breast implant safety communication, warning that it has also received reports of squamous cell carcinoma and other lymphomas occurring in breast tissue capsules around implants through postmarketing surveillance. However, these breast implant cancers were different from the BIA-ALCL cases, which have resulted in prior warnings.