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Breast Implant Illness: Are Breast Implants Safe?

By Luke J. Curtsinger, III, MD

By Luke J. Curtsinger, III, MD

Most women who choose breast augmentation with implants have the surgery and enjoy their new shape without any problems. There are risks associated with any surgical procedures, and a small number of women do experience issues after a breast augmentation. The majority are minor complications, but you may have heard of women feeling sick after breast implant surgery. That’s known as breast implant illness, and while the risk of developing serious breast implant illness are relatively low, it’s important to know about them.

Surgical Risks

There are risks associated with any surgery. Before you decide on a breast augmentation, your surgeon will discuss the risks with you in detail. After you’ve asked any questions you have, you’ll be asked to sign a surgical consent form. This indicates that you understand the risks and consent to the surgery.

Some of the risks associated with breast implant surgery can be complications of the surgery itself. Others are problems that may arise afterwards. Risks and complications of breast implant surgery include:

    • General anesthesia risks, such as an allergic reaction

    • Bleeding and/or hematoma

    • Seroma, a buildup of fluid around the breast implant

    • Infection

    • Changes in breast and/or nipple sensation – This may include temporary or permanent loss of sensation.

    • Rupture and/or leakage of the breast implant – The risk of rupture increases with the age of the implant.

    • Capsular contracture, which can develop due to excessive scar tissue formation

Learn more about the risks associated with breast augmentation surgery here.

What Is Capsular Contracture?

It’s normal for a certain amount of scar tissue to develop around a breast implant. But sometimes an excessive amount of scar tissue can form, resulting in a condition called capsular contracture. When this happens, the excess scar tissue forms a tight capsule around the implant. This forces it to contract, displacing the implant from its intended location. The contraction is often painful and can alter the look and feel of the affected breast.

The risk of having a capsular contracture is about 1 in 20. Complications such as hematoma, seroma, or infection can increase the risk. This is because these conditions can cause the formation of excess scar tissue, which can in turn lead to capsular contracture. Having an autoimmune disorder can also increase the risk.

Around 75% of capsular contracture cases develop within the first two years after surgery. However, in some people, it may develop later.

Can It Be Prevented or Reversed?

While it’s not possible to completely eliminate the risk of capsular contracture, choosing textured breast implants over smooth implants and having the implant placed beneath rather than over the pectoral muscles may help to reduce the risk. It’s thought that these measures are helpful because they limit the formation of scar tissue around the implant, which in turn reduces the likelihood of contraction of the capsule.

Properly following your surgeon’s instructions post-surgery is also important because good aftercare helps prevent complications during recovery. Some complications, such as infection and inflammation, can also cause scar tissue to form, so taking care of yourself during recovery helps your breasts stay healthy in the long term.

If you do develop capsular contracture, the displaced implant can be removed and replaced during a revision surgery.

What Is Breast Implant Illness?

Breast implant illness (BII) isn’t an officially diagnosable condition. Instead, it’s a range of symptoms that some women may experience after breast implant surgery. These symptoms tend to impact each person differently. Women with BII don’t all have the same pattern of symptoms, but what they experience may include:

    • Skin problems, such as rashes and irritation

    • Dry mouth and/or dry eyes

    • Muscle and/or joint pain

    • Chronic fatigue

    • Memory and/or concentration issues

    • Headaches

    • Hair loss

    • Sleep disturbances

    • Gastrointestinal problems

    • Anxiety

    • Depression

BII can develop any time after having breast implant surgery. Some women develop symptoms almost immediately. Others don’t have symptoms until several years later.

The exact cause of BII is unknown. It may be an autoimmune or inflammatory condition triggered by exposure to breast implant materials such as silicone. Some doctors have found that women with pre-existing or a family history of autoimmune disease may have a higher risk of developing BII. The risk of developing BII may be higher in cases where an implant ruptures, but women can develop BII even if their implants remain intact.

Can BII Be Treated?

The main treatment for BII is to have the breast implants removed. In most women, symptoms improve or go away completely after implant removal surgery.

What Is BIA-ALCL (Breast Implant Associated Anaplastic Large Cell Lymphoma)?

While breast implants don’t directly cause cancer, there are known links between certain kinds of cancer and breast implants. One of these is BIA-ALCL, a kind of cancer that develops in some people after breast implant augmentation. The risk of developing BIA-ALCL after implant surgery is extremely low. Worldwide, there have been just 733 cases reported to the FDA as of January 5, 2020. BIA-ALCL is not actually breast cancer but a kind of non-Hodgkin’s lymphoma that affects T lymphocytes.

BIA-ALCL leads to the formation of a mass near the site of the breast implant, along with pain and persistent swelling. Fluid may collect around the implant, and some people also have capsular contracture. BIA-ALCL may develop at any time after implant surgery. Some people develop the cancer several years after having breast implant surgery.

Can BIA-ALCL Be Treated?

This cancer can be fatal if not found and treated promptly. This means it’s important to have regular breast checkups after breast augmentation surgery. Treatment of BIA-ALCL is typically successful when the cancer is found early. It consists of surgery to remove the implant and surrounding scar tissue. If the cancer has spread beyond the breast, treatment may also include radiation therapy and chemotherapy.

Can BIA-ALCL Be Prevented?

Researches are still learning about this cancer, but, according to the FDA, the risk of breast implant cancer is higher when textured breast implants are used. Based on this information, the FDA issued a recall of all BIOCELL textured breast implants and tissue expanders in 2019. These products have been removed from the market. At Savannah Plastic Surgery do not use textured implants in any of our breast augmentations.

Because the risk of developing BIA-ALCL is low, the FDA says there is no need to have textured implants removed if you have them. Instead, they recommend having regular breast checkups. It’s also important to self-monitor for signs of breast implant cancer, such as swelling or pain in the breasts.

Stay Informed to Reduce Your Risk of Breast Implant Problems

There are risks associated with breast implants, just as there is risk involved in any kind of surgery. The important thing is to be informed and talk with your surgeon about anything you’re unsure of, understand the risks, and know what signs and symptoms to look out for. A consultation is the perfect time to do that. If you’re interested in learning more about breast augmentation, breast implants, or any other procedure, schedule a consultation today.