Breast Surgery

Update on BII – Do you have Breast Implant Illness?

Feeling fatigue or pain after having Breast Implants? – Find out about Breast Implant Illness Symptoms & BII Solutions

  • Do you have breast implants?
  • Are you worried about specific complications associated with breast implants?
  • Interested in finding out more about Breast Implant Illness?

Breast implant illness (BII) refers to a broad range of unexplained symptoms that patients can experience after cosmetic or reconstructive breast surgery using breast implants. Currently, there is a lot of medical research happening but BII is not yet a recognised medical condition and there is no real diagnostic criteria for it.

Dr Michael Kernohan is a renowned specialist plastic surgeon performing breast surgery in Sydney’s Southwest Suburbs and the Southern Highlands. He is an expert in breast surgery and committed to delivering optimal results to his patients. Here he discusses the latest on Breast Implant Illness.

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What Causes Breast Implant Illness?

Because medical professionals do not officially recognize BII as an illness, it is difficult to identify the exact cause of this condition. Some patients are predisposed to having an immune reaction to certain materials that are used to create breast implants. This can cause inflammation that leads to various unpleasant symptoms. Recent evidence suggests that substances from breast implants such as silicone and platinum could trigger an immune reaction in some patients. In addition, the immune system can also react to the method of breast implant insertion and other surgical techniques.

Is BII real?

  • The FDA, ASERF Medical researchers like Dr Caroline Glickman & Dr Pat McGuire, plastic surgeons, and other medical professionals are conducting studies to determine more about BII – breast implant illness. Some of the recently published studies have shed some light on the matter. A 2019 study published in the Expert Review of Clinical Immunology assessed the role of silicone implants in promoting breast implant illness. Using data derived from patients with breast implant illness and other medically implanted devices, the researchers found a clear pathogenic relationship between silicone breast implants and BII. In addition, they also found that the removal of the implants resolved the associated symptoms in most patients but not all.

Download Dr Michael Kernohan’s Cosmetic Breast Surgery Guide

Symptoms of Breast Implant Illness

If you have BII, you may experience a wide array of symptoms. The most common symptoms can be categorized into the following:

  • Musculoskeletal symptoms: these include pain in the muscles and joints
  • Cognitive symptoms: these include fatigue, difficulty concentrating, memory loss, depression, anxiety, sleeping problems, and brain fog
  • Systemic symptoms: these include dry eyes, dry mouth, rashes, and vision problems

How do you know if you have BII?

Dr Kernohan Treats a Capsular Contracture by Removing the Implants – YouTube Shorts

It is hard to say if you really have BII because there are no diagnostic criteria for this condition. If you have breast implants and you experience any of the following symptoms, then you may be suffering from BII:

  • Anxiety
  • Brain fog
  • Depression
  • Difficulty concentrating
  • Dry eyes
  • Dry mouth
  • Fatigue
  • Joint pain
  • Memory loss
  • Muscle pain
  • Rashes
  • Sleeping problems
  • Vision problems

How do you know if your body will reject breast implants?

You cannot tell whether your body will reject the breast implants. During your consultation, Dr Kernohan will conduct a thorough assessment of your general health to determine the best type of implant that will suit your body frame, lifestyle, and aesthetic goals.

As with any surgery, there is a chance that you can develop complications. If you experience any of the following signs and symptoms, consult with your surgeon immediately:

  • Asymmetry (uneven size, shape, or breast level)
  • Bleeding
  • Breast sagging
  • Capsular Contracture (tightening of the scar tissue around the implant)
  • Changes in the sensation of the nipple or breast
  • Chest wall deformity
  • Collection of blood near the surgical site
  • Collection of fluid around the implant
  • Dead skin or tissue in the breast area (necrosis)
  • Delayed wound healing
  • Extrusion (skin breakdown that causes the implant to appear through the skin)
  • Hard lumps under the skin around the implant
  • Implant leakage or rupture
  • Infection
  • Injury or damage to the tissues
  • Malposition/ displacement of the implant
  • Pain in the nipple or breast area
  • Poor cosmetic results
  • Severe inflammation, redness, irritation, or bruising
  • Skin rash
  • Swollen or enlarged lymph nodes
  • The implant can be felt through the skin
  • Thinning and shrinking of the breast skin
  • Wrinkling/rippling of the implant
Watch Dr Kernohan Explains What Happens in Breast Reconstruction Surgery – Youtube Video
Watch Dr Kernohan Explains How Does One Know if Breast Implants Need Replacing

FAQs about Breast Implant Illness

What is breast implant illness (BII)?

  • It refers to a broad range of unexplained symptoms that you can experience after cosmetic or reconstructive breast surgery with implants. This can include musculoskeletal symptoms, cognitive symptoms, and systemic symptoms. In some cases, these symptoms are severe enough to affect the patient’s quality of life. This may require the removal of breast implants to get relief from the symptoms.

What are the chances of getting a BII?

  • Unfortunately, it’s hard to know your chances of getting breast implant illness. While one study found a causal association between silicone breast implants and BII, more studies are needed to confirm a strong link between the different types of breast implants and BII.  If you’re considering getting breast implants for the first time or replacing your existing implants, talk with Dr Kernohan about whether you are at risk for BII. During your consultation, Dr Kernohan will assess for risk factors of BII and will provide alternative surgical options.

Does everyone with implants get BII?

  • Not everyone with breast implants has BII. A study even found that there is a causal association between silicone breast implants and BII. Another study reported that BII is more likely to occur in people who have a family history of autoimmune conditions. More recent research found a link between a history of anxiety, high social media use and tattoos in BII patients.

How long does it take to recover from BII?

  • Breast implant issues can affect each person in a different manner and can vary. In most cases, your breast implants will be removed if BII is significantly affecting your quality of life. Once removed, your symptoms usually start to resolve and your body will start to heal. Your recovery can range from several weeks to months. There is no guarantee that the implants are the cause of your symptoms and symptoms may persist even after implant removal.

Do I need to remove the whole Breast Implant Capsule – ‘enbloc’ removal?

  • Latest research suggests that removing the whole breast capsule or part of the capsule gets the same results. Enbloc removal also has higher risks as it can puncture the lung.

How do I know if my breast implant is infected?

  • Breast implant infection is very rare and can usually be avoided with proper surgical techniques and wound care. This usually tends to arise from bacteria that enter your body either during or after the surgery. Since breast implant surgery requires inserting foreign materials in your breast, it can significantly increase your risk of developing an infection compared with non-implant surgery. Once the bacteria come in contact with your breast implants, your body’s immune system cannot easily fight off an infection. Even with the administration of antibiotics, there is still a chance that you may get an infection.

If you develop a breast implant infection, you may experience the following signs and symptoms:

  • Breast pain
  • Chills
  • Fever
  • Pus draining from the surgical wound or in the surrounding area
  • Redness
  • Swelling

What are the safest Breast implants?

  • All FDA-approved breast implants are considered safe. However, the decision on breast implant selection should not be focused on the assumed safest choice. To determine the best type of breast implant that will best suit your desired results and body frame, Dr Kernohan will assess your general health and expectations during the consultation. Before your breast augmentation with implants surgery, you will be provided with detailed information regarding the different types of implants.

Does Medicare or Health insurance cover breast implant illness?

  • Unfortunately, most insurance companies do not consider breast implant illness as a medical condition and do not cover the costs associated with breast implant removal. However, if you can prove that it is medically necessary to remove the breast implants, there’s a possibility that some of the costs can be covered. Your insurer will want to know the exact reason why you had a breast augmentation with implants in the first place.

Do BII symptoms come and go?

  • The symptoms of breast implant illness can often mimic the symptoms of other medical conditions or diseases. For this reason, healthcare providers have difficulty determining whether or not the symptoms are actually caused by breast implants. In addition, the symptoms associated with breast implant illness can be vague and may come and go over time.

Can BII cause weight gain?

  • The symptoms associated with breast implant illness may vary from patient to patient. Some can experience weight loss while others weight gain. Since BII can lead to depression and anxiety, some affected individuals can gain weight through stress eating.

How can I recover from BII?

  • Evidence suggests that breast implant removal or explantation can significantly reduce the symptoms associated with breast implant illness.

A 2020 study published in the Annals of Plastic Surgery evaluated 750 patients who underwent explantation by a single surgeon over 2 years. The researchers compared the symptoms experienced by the patients before and after surgery. Although BII encompasses a broad range of symptoms, the subjects in this study exhibited significant and sustained improvement in 11 common symptom domains such as numbness and tingling in the extremities, joint and muscle pain, hair loss, memory loss and other cognitive problems, dry eyes and vision changes, chronic fatigue, breast pain, rashes and/or hives, food sensitivity/intolerance, flu-like symptoms and/or low-grade fever, and difficulty breathing.

A 2017 study published in the Immunologic Research journal compared one hundred patients with autoimmune/inflammatory syndrome due to silicone implant incompatibility syndrome with one hundred patients with adjuvant breast disease. Clinical manifestations between the two groups were comparable. Symptoms such as fatigue, joint pain, muscle pain, fever, cognitive impairment, and severe neurological manifestations were observed in both groups. Of the 54 patients who underwent removal of their silicone breast implants, 50% of them reported significant improvements in their symptoms.

How long after explant do BII symptoms go away?

  • To date, breast implant removal surgery is the most effective management for BII. This can significantly reduce the prevalence and severity of symptoms associated with the condition. It is important to keep in mind that the recovery time after implant removal as well as symptom improvement may vary from patient to patient. Some may report improvements after several months while some may experience symptom relief after a couple of years.

Does BII appear immediately after breast augmentation?

  • The symptoms of BII can appear any time after your breast implant surgery. It can occur immediately or you may develop it years later. If you are suffering from debilitating symptoms following your breast augmentation, it is recommended to consult immediately with a medical professional for further evaluation and management.

Further Reading and Latest Medical References about Breast Implant Illness:

Dr Michael Kernohan MBBS, MSc, BDS, MRCS, FDSRCS, FRCS(Plast), FRACS (Plast

Dr Michael Kernohan is a highly experienced Plastic, Reconstructive and Cosmetic Surgeon, fully qualified in both Australia and the UK. He has had extensive training, holding qualifications in both dentistry and medicine. His training path has taken him around the world acquiring skills from some of the world’s best surgeons.