In Depth

What is breast implant illness?

Thousands of women have reported symptoms including chronic pain and fatigue following the plastic surgery procedure

Women should be warned about the potential risk of a condition known as breast implant illness (BII) before going under the knife, according to the British Association of Aesthetic Plastic Surgeons (BAAPS).

Tens of thousands of women worldwide have used online forums to describe their experiences after allegedly developing BII. The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) alone received 1,586 Adverse Incident Reports for breast implants between 2014 and May 2019. 

BII is not an official diagnosis, with “little scientific evidence” of its existence, reports the BBC. But with increasing numbers of patients claiming to have suffered life-changing health problems after getting implants, surgeons are calling for urgent research.

What is BII?

The term covers a very broad range of non-specific symptoms, including hair loss, fatigue, irritable bowel syndrome, autoimmune conditions such as lupus, and fibromyalgia, a long-term condition that causes pain all over the body. Other complaints range from headaches, photosensitivity and brain fog to chest pain, chills and sleep disturbance.

Patients who have experienced these symptoms have tried a variety of strategies to combat them, such as changing diets and lifestyles, but most have concluded that their breast implants are to blame, BAAPS reports. 

Some women “say they returned to full health after having their implants removed”, adds the BBC.

Fitness instructor Naomi Macarthur told the broadcaster that she suffered the “most horrific symptoms”, including “severe pain in my stomach”, after getting implants in 2014. 

“And the tiredness was like I had run a marathon and dug a million trenches and I hadn’t done anything,” said Macarthur, from Brighton. “Writing with a pen was too tiring.”

Doctors told her that the illness was unrelated to the implants. But after finding an online support group for BII, Macarthur had hers removed last year, and says her symptoms began to disappear within days.

Sometimes, however, the symptoms return, says Dr Michael Burgdorf, a surgeon at the Music City Plastic Surgery clinic in Tennessee.

“That’s tough for us as surgeons because we do see these patients that come in with these symptoms, we want to take care of them, we want to be advocates for them, and we’re on their side, so we don’t want to just dismiss these symptoms,” Burgdorf told Nashville-based network NewsChannel 5.

Is there any scientific evidence that it exists?

Not much, as yet.

“Though breast implant illness has been recognised as a condition that affects some patients with breast implants, there is currently a lack of good evidence that the breast implants are the cause,” says BAAPS.

“The variety of generalised symptoms reported have made it difficult to ascertain the true features of the illness and so an objective diagnosis can be difficult. It is believed in some patients, the cause may be psychological rather than physical. Explantation appears to work for only 50% of patients.”

Naveen Cavale, the UK’s national secretary for the International Society of Plastic Surgery, 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. But, to me, as a doctor, it makes no scientific sense.”

Medical industry watchdog MHRA says that the majority of the more than a million women who have undergone breast implant operations in Britain have not reported problems.

All the same, BAAPS and other plastic surgery associations have begun warning patients about the potential risk of BII.

“Patients need the most up-to-date information possible, with the caveat that breast implant illness is poorly understood,” says Nora Nugent, consultant plastic surgeon of BAAPS. “So it’s going to be difficult to give absolute information.”

Surgeons are hoping that an ongoing US Food and Drug Administration (FDA) investigation into BII will shed new light on the issue.

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