Breast Implant Illness: The Main Side Effect of Breast Augmentation

Breast augmentation is a surgical procedure that aims to increase the breasts' size or alter their shape. Breast implants or fat grafts can improve the appearance of the breasts through this operation. In this article, we first look at different types of breast implants and then introduce a serious complication of boob job, i.e., breast implant illness.

What Is Breast Augmentation?

Breast augmentation, also known as a boob job and augmentation mammoplasty, is a body cosmetic surgery involving placing breast implants inside the breast tissue to make them look larger, firmer, and more projected. This operation is mainly done for the following reasons:

• To increase the size of the breasts
• To make the breasts look even
• To improve the patient's self-esteem
• To make the saggy breasts firmer after breastfeeding or significant weight loss 
• To restore the breast tissue after cancer treatment or injury

Read more: What Is the Process of Getting Breast Implants?

Types of Breast Implants

Breast implants differ in shape, size, projection, and material. Depending on your expectations and current breast shape, the surgeon may use either saline-filled or silicone-filled implants in your operation. In the following, these two types of breast implants are introduced briefly. 

Saline-filled breast implants

This implant consists of a hard silicone shell filled with saline solution. These implants are mostly suitable for those wishing to have round and prominent breasts, and it has a less natural look.

Silicone-filled breast implants

Silicone implants also have a hard shell but are filled with a medical-grade silicone gel. Two famous shapes of silicone implants are round (anatomical) and teardrop (gummy bear or contoured). These implants have a lighter and softer texture, so they feel and look more natural. 

Common Complications of Breast Implants 

After the boob job, you will experience moderate pain, tightness, swelling, bruising, and redness in your chest, disappearing within two weeks following the operation. Besides these temporary discomforts, you may face some common complications and problems after the surgery, such as:

• Red and prominent scars on the surgical area;
• Feeling hardness in the breast tissue;
• Lumps and bumps due to implant leakage or accumulation of fluid under the skin;
• Rotation or misplacement of the implant(s);
• The wrinkle of the breast implants, which can be seen through your skin;
• Mild infection and fever; and
• Uneven look at the breasts. 

Rare Complications of Breast Implants 

In addition to the abovementioned complications, breast implants have several rare side effects. 

• Breast implant illness (BII);
• Damage to the nerves and blood vessels of the nipple;
• Temporary or permanent change in the sensation of the breasts;
• Development of a highly rare cancer, namely anaplastic large cell lymphoma (ALCL);
• Capsular contracture;
• Severe infection which requires removal of the implant;
• Allergic reaction to the anesthetics used during the operation;
• Formation of hypertrophic scars on the breasts;
• Damage to the breast tissue and milk ducts;
• Formation of blood clots in veins; and
• Severe bleeding during and after the procedure. 

What Is Breast Implant Illness?

Breast implant illness, commonly known as BII, refers to various symptoms that emerge after breast augmentation surgery and can impair one's health. Breast implant illness is not an official medical term as its causes and symptoms are still under investigation; however, they are real and serious.

There are different hypotheses about the cause of BII, such as having an autoimmune disease like lupus or rheumatoid arthritis, having a connective tissue disorder, having multiple allergies, and having an inflammatory reaction to the implants. However, experts still debate about the main cause of this disease.

Breast Implant Illness Symptoms

There are many symptoms that people with breast implant illness experience after a boob job. Remember that there is no specific time for these symptoms to appear, so you should seek help whenever you have them, even years after your breast augmentation surgery. Read on to learn more about the common symptoms of BII.

• Pain in chest, muscles, bones, or joints;
• Dry mouth and eyes;
• Brain fog, confusion, amnesia, and difficulty concentrating;
• Chronic fatigue and sleep disturbance;
• Unexplained breathing problems;
• Skin and hair problems such as rashes, hair loss, blistering, and hives;
• Weight changes;
• Chronic headaches; and
• Gastrointestinal problems.

Who Is More at Risk of Breast Implant Illness?

Various tests and examinations are mandatory before a boob job as the underlying conditions increase the risk of getting breast implant illness. People with the following conditions should reconsider having this operation because they are more prone to develop BII.

• Lupus;
• Rheumatoid arthritis;
• Lyme;
• Scleroderma;
• Chronic allergies;
• Fibromyalgia;
• Frequent migraines;
• A history of depression;
• Thyroid problems;
• Irritable bowel syndrome (IBS); and
• Arthritis.

Breast Implant Illness Diagnosis

There has been no actual test or evaluation to diagnose breast implant illness. The only way to diagnose this disease is by looking into the patient's medical history, checking the symptoms, and examining what triggers these symptoms. Based on your symptoms and underlying conditions that caused BII, your plastic surgeon refers you to a rheumatologist, endocrinologist, dermatologist, or neurologist. The treatments suggested by these specialists should alleviate your pain and discomfort; however, if the problems do not go away, you should have your implants removed. 

Breast Implant Illness Treatment

Although removing breast implants has been the best treatment for BII, it may not resolve all your symptoms. In this treatment, which is sometimes called en bloc capsulectomy or total capsulectomy, the surgeon removes both implants and their capsules completely. Since BII can develop with all kinds of implants, it is suggested not to replace them with new ones; instead, you can go flat or get a breast reconstruction surgery (with a flap or fat graft) to have shapelier breasts. Having a healthy lifestyle, exercising daily, and avoiding stress will decrease your BII symptoms and promote healing after en bloc capsulectomy.

It should also be mentioned that if you have few BII symptoms or are minimally bothersome, the doctor offers some treatment methods to alleviate the symptoms and keep the implants in their place. 

Should I Have My Breast Implant Removed or Not?

Whether to remove the breast implant and its capsule after BII is a tough decision and requires lots of research and consultation; almost 30% of women with BII have replaced their implants to decrease their symptoms, and 50% decided to remove them completely. Many patients reconsider implant removal as they are worried about how their breasts will look after the operation. Thanks to medical advancements, three surgical methods are used today that alleviate BII symptoms and prevent breast sagginess and unevenness. 

• Removing the breast implants but leaving its capsule in the chest.
• Removing the implants but leaving part of the capsule in the chest (subtotal capsulectomy).
• Removing the implants and the whole capsule from the breasts (total capsulectomy).

As mentioned earlier, the best treatment method for breast implant illness is total capsulectomy, as the breast implants, their capsule, and scar tissue are all removed from the body. However, this method requires a large incision and involves significant scarring. All the methods mentioned above should be noted that the surgeon transfers fat grafts or flaps (tissues or muscles) to the breast so that the patient faces a less dramatic transition after the operation.

FAQs About Breast Implant Illness

1) What are the chances of getting breast implant illness?

According to FDA, the chance of getting breast implant illness is nearly 1%.

2) How can I know If I have BII?

To diagnose BII, your doctor will check your medical background and examine your symptoms. If you think you have BII, schedule a consultation session with your surgeon and discuss your signs and symptoms with them.

3) What is the main cause of breast implant illness?

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) or Shoenfeld's syndrome is considered the main cause of breast implant illness. 

4) What is the best treatment for BII?

The most effective treatment for BII is the total removal of breast implants. Removing the implants and their capsule often -but not always- improves the BII symptoms and minimizes the discomfort. 

5) Is breast implant illness the same as BIA-ALCL?

The short answer is no. BIA-ALCL is a kind of lymphoma associated with textured breast implants and may cause chest swelling, pain, and lumps. Breast implant illness, on the other hand, is an autoimmune/inflammatory reaction to implants and causes joint pain, hair shedding, mental issues, breathing problems, etc.

6) What are the first signs of breast implant illness?

 The early signs of BII include extreme fatigue, skin rash, gastrointestinal problems, and pain in the chest and joints.