Breast implant illness — a collection of troubling physical symptoms, ranging from chronic pain to brain fog — may not be an official medical diagnosis, but it’s being taken more and more seriously by physicians. And that includes U.K. plastic surgeons, who said on Monday that any patient seeking implants should be warned about the possible complication.
"Surgeons should be warning patients about breast implant illness,” Nora Nugent, consultant plastic surgeon with the British Association of Aesthetic Plastic Surgeons (BAAPS), told the BBC’s Victoria Derbyshire show. “Patients need the most up-to-date information possible, with the caveat that breast implant illness is poorly understood. So, it's going to be difficult to give absolute information."
Further, the U.K.'s National Secretary for the International Society of Plastic Surgery, Naveen Cavale, told the BBC, "As far as some of my patients are concerned, breast implant illness is a very real thing for them, and I have no reason to doubt them.” Even though, to her, as a doctor, the illness “makes no scientific sense,” she said that talking about it with patients is important.
“The proper plastic surgery associations, such as ourselves, have started advising we do so,” Cavale said, “which I think is a good thing for patients to make more informed decisions."
Discussion of breast implant illness has also gained traction in the U.S., where about 400,000 women get breast implants annually — 300,000 for cosmetic reasons and 100,000 for post-mastectomy reconstruction related to breast cancer. And breast augmentation has been the top plastic surgery procedure since 2006, according to the American Society of Plastic Surgeons.
In March, the U.S. Food & Drug Administration (FDA), prompted by reports of illness from thousands of women, held a two-day conference about breast implant safety, including reports of illness, at which the agency’s general and plastic surgery devices panel heard from patients, advocates, researchers and the industry itself.
“While the FDA doesn’t have definitive evidence demonstrating breast implants cause these symptoms,” the FDA noted in a post-conference statement, “the current evidence supports that some women experience systemic symptoms that may resolve when their breast implants are removed, referred to by some patients and health care professionals as breast implant illness. We believe women considering a breast implant should be aware of these risks.”
Here's what we know about breast implant illness:
The reported symptoms are extremely varied, often making the illness a difficult mystery to solve.
The FDA has discovered more than 90 symptoms relating to breast implant illness in its Medical Device Reporting database. They include: acid reflux, ear ringing, easy bruising, fibromyalgia, hair loss, IBS, muscle pain and rheumatoid arthritis. Many studies over the years have both found connections between implants and illness and not found connections. “I had the most horrific symptoms… severe pains in my stomach, like gut problems,” and extreme exhaustion, Naomi MacArthur, a fitness instructor, told the BBC. “It’s been absolutely horrific, the amount of pain and suffering that I had to go through, and going to clinics and hospitals and saying to doctors, ‘I’m so ill’ and they just saying it’s nothing to do with the implants.”
Reports of breast implant illness are rare.
The FDA found 1,328 reports related to breast implant illness over a 10-year period in its Medical Device Reporting database. The agency conducted a query of its database for all reports posted between January 1, 2008, and October 31, 2018, referring to a saline- or silicone-filled breast implant and related symptoms. The majority of the reports were by patients; they concerned “health issues in both breast implant patients and children born to them,” the FDA reports, stressing that while the MDR database is “a valuable source of information, this passive surveillance system has limitations, including incomplete, inaccurate, untimely, unverified, or biased data in the reports.”
Many women who say they are experiencing symptoms of breast implant illness find each other online for support.
Facebook support groups, including Breast Implant Illness and Healing by Nicole (and its related website), a closed group with more than 86,000 members, are used as places for peer support and education. Others, including Breast Implant Illness Detox and Healing, and Breast Implant Illness Healing and Information, have 2,400 and 1,600 members, respectively, with many women’s testaments to healing after having their implants surgically removed.
The removing of implants, called “explanting,” is what resolves the symptoms, say some patients.
“Literally, the next day, my skin tone completely changed,” Christy Avila tells Yahoo Lifestyle, adding that she felt “60 percent better” within a month of explanting. Avila, who received implants as part of post-mastectomy reconstructive surgery following breast cancer treatment, spoke at the FDA hearing about her symptoms of breast implant illness — including brain fog, memory loss, hair loss, insomnia, pain and heart palpitations, she says. While some doctors — including Grant Stevens, MD, a plastic surgeon with more than 30 years of experience with breast surgery, and a speaker at the recent FDA hearings — don’t believe such instant relief is possible, Avila stresses that it has been life-changing. She now advocates for women to get their implants removed or skip getting them in the first place, opting to “go flat” after mastectomy.
There are many other reasons for explanting, though.
Grant, who does many explant surgeries, says he’s supportive of a woman wanting to remove her implants, for whatever reason. “They have the right to put them in and they have the right to take them out,” he tells Yahoo Lifestyle. But, he adds, “The number one reason a woman removes her breast implants is because she wants smaller breasts,” so oftentimes these patients will wind up doing an implant exchange, swapping a larger implant for a smaller one. Other reasons for explanting include complications such as pain, sometimes from an issue called capsular contracture, which is when the normal capsule of scar tissue that forms around an implant becomes unusually hard. “Only the next reason down was that women had symptoms… women who come in and say, ‘These are making me feel sick.’ So explantation is not synonymous with” breast implant illness, Grant says.
Breast implant illness is different from the cancer — breast-implant associated anaplastic large cell lymphoma (BIA-ALCL) — that’s been linked to certain types of implants.
Also at the FDA hearings in the spring, there was discussion of BIA-ALCL, of which there have been 457 cases in the U.S. since 2011, according to the FDA. That’s including the deaths of nine women. BIA-ALCL is most likely caused by textured breast implants, the FDA said, which have a suede-like coating. But unlike France and Canada — and perhaps soon Australia — which have banned certain types of implants related to this cancer, and the 38 countries that have banned implants made by Allergan, the FDA has opted to leave the implants on the market, aiming to continue tracking and studying cases instead. (UPDATE: On July 24, Allergan recalled the implants in question across all markets.) The actual risk of BIA-ALCL in women with textured implants is still a matter of discussion, with the FDA saying it ranges from 1 in 3,817 to 1 in 30,000, but according to Australian health officials, it could be as high as 1 out of every 1,000 women with breast implants.
That hasn’t stopped some women who have been affected by the cancer from speaking out about it. “Everybody's looking for a cure for cancer,” Raylene Hollrah, who suffered from BIA-ALCL after having had breast cancer, told the Today show on Monday. “We can cure this cancer. They need to be removed from the market.”
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