What is breast implant illness?
⚠️ When to contact your surgeon or seek urgent care
If you have breast implants and experience sudden swelling, redness, warmth, or pain around an implant, a new lump, or signs of infection such as fever, contact your surgeon promptly. Swelling that develops years after implant placement can sometimes signal a rare condition called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and should be evaluated without delay. For any severe or rapidly worsening symptoms, seek emergency care.
Short answer
Breast implant illness (BII) is a condition where people with breast implants develop a wide range of whole-body symptoms, such as fatigue, joint pain, and brain fog. The exact cause is not fully understood, but research points to immune system responses, chronic inflammation, and possibly bacteria on the implant surface. Most people who choose to have their implants removed report significant improvement in symptoms.
What the research shows
Breast implant illness (BII) describes a collection of symptoms that some people develop after receiving breast implants. The most commonly reported symptoms include fatigue (reported by about 58% of BII patients), joint pain (51%), and muscle pain (44%). Other reported symptoms include headaches, hair loss, chills, rashes, chest pain, and difficulty thinking clearly. [1] [4]
Symptoms tend to appear on average about 6 years after implant placement. [1] Researchers have proposed several possible causes, including the immune system reacting to the implant material, bacterial biofilms forming on or around the implant, and ongoing low-level inflammation of the tissue capsule that forms around the implant. [6] [2] Signs of inflammation in the capsule surrounding the implant were found in over half of BII patients studied. [1]
Is BII a real condition?
This is a topic of active scientific debate. A large systematic review and meta-analysis concluded that BII is a real, multifactorial clinical condition involving immune system changes, chronic inflammation, and microbial factors. [1] A cohort study using Bradford Hill criteria (a standard scientific tool for evaluating cause and effect) concluded there is a causal link between silicone breast implants and BII. [2] However, other experts point out that the available studies have important limitations, such as selection bias and lack of control groups, which make it hard to draw firm conclusions. [3] [4] Some researchers call for more rigorously designed studies before a formal syndrome definition is established. [5] [6]
The scientific community agrees that BII deserves serious attention and that patients' symptoms are real and meaningful, even while the underlying biology is still being studied.
What happens after implant removal?
Many patients who choose to have their implants removed (a procedure called explantation) report significant relief. Across a large meta-analysis, about 82% of patients reported symptom improvement after removal. [1] A cohort study of 229 patients found that explantation with complete removal of the surrounding tissue capsule reduced both the number and severity of symptoms in nearly all participants. [8] Implant removal is currently considered the most effective treatment for BII. [2] If you are considering this, it is important to discuss the options with a board-certified plastic surgeon who can help you weigh the benefits and risks.
What to ask your surgeon
If you have breast implants and are experiencing unexplained systemic symptoms, consider speaking with your surgeon about: whether your symptoms could be related to BII or another condition; screening for autoimmune conditions, since about 1 in 5 BII patients in studies had an autoimmune diagnosis; [1] the pros and cons of explantation versus ongoing monitoring; and what type of explantation procedure (with or without capsule removal) might be appropriate for you. [8] Social media discussions about BII are widespread, but decisions about your care are best made in partnership with a qualified medical professional. [4] [5]