BREAST IMPLANT ILLNESS: WHAT WOMEN NEED TO KNOW
The reason I am writing a blog on Breast Implant Illness (BII) is because I am seeing a number of patients who are not making the expected progress in the expected amount of time. The ability of Long Covid to reactivate old infections and conditions is well-documented in the medical literature, but we now have effective tools to address these. The common denominator of these treatment-resistant patients is that they all have breast implants, some for many years. This prompted me to explore the latest research, clinical experience and patient stories about Breast Implant Illness. To find out more, and what every women should know before making an informed decision, please read on …
Recognition of Breast Implant Illness (BII)
At one time (before 1988) women in the UK were gaslit by medical professionals about Breast Implant Illness. They were told there was no link between silicone breast implants and systemic illness, that it was “all in their head and why didn’t they take an antidepressant.” Fast forward to 2020 and the MHRA’s published guidelines recognising Breast Implant Illness as a real pattern of physical symptoms reported by many women who have breast implants. The MHRA is the UK’s Medicines and Healthcare products Regulatory Agency. In 2019, the FDA (U.S. government agency that regulates safety of medicines medical devices) began to place various warnings on the packaging of implants: a Black Box warning for potential severe side effects, that breast implants are not lifetime devices, that they have been associated with a rare type of lymphatic cancer (implant-associated anapaestic large cell lymphoma), that some patients report systemic symptoms referred to as Breast Implant Illness (BII) also known as ASIA (auto adjuvant associated autoimmune problem), or SSPI (systemic syndrome associated with breast implants). This is a real step forward to getting more physicians and consultants to discuss Breast Implant Illness with concerned patients.
Breast Implant Concerns
There are two main types of breast implants - silicone gel implants (most commonly used) and saline implants which still have a silicone outer shell but are filled with sterile salt water (saline). Both types of implants contain silicone. The complication rate for breast implants is estimated to be around 30% and there are three main categories of concern with breast implants:
1.Capsular contracture: One of the most common and recognised complications. When the implant is placed in the body, the immune system naturally forms a thin layer of scar tissue around it called a capsule. In some women, this capsule becomes unusually thick, tight and hard. As it contracts, it squeezes the implant, causing the breast to feel firm, change shape or even become painful.
2.Breast Implant-Associated Anaplastic Cell Lymphoma (BIA-ALCL): is a rare type of cancer of the immune system, not breast cancer, that can develop in the scar tissue or fluid surrounding a breast implant. It has been linked primarily to textured breast implants. When diagnosed early, it is often successfully treated by removing both breast implant and surrounding scar tissue.
3.Breast Implant Illness (BII): is a term used to describe a wide range of symptoms that some women experience after having breast implants. The symptoms are so varied that they are difficult for a conventionally trained practitioner to think with. Commonly reported symptoms affect multiple body systems and can include: persistent fatigue, brain fog, muscle and joint pain, headaches, dry eyes and mouth, hair loss, skin rashes, anxiety, palpitations, digestive problems, and autoimmune or allergy-like symptoms. Some women notice their symptoms soon after implant surgery; others many years later.
Numbers One and Two are easily diagnosed. Number three is much harder to diagnose as there is no single blood test for Breast Implant Illness. Diagnosis therefore, depends on excluding other causes first. So, when standard well formulated protocols fail to work and breast implants are present, BII should be considered.
How does the immune system respond to a foreign object?
The immune system is designed to recognise and respond to anything it identifies as a foreign object. When a breast implant is placed in the body, the immune system cannot remove it, so it forms a layer of scar tissue around the implant, known as a capsule. This is a normal healing response. In some people, however, the ongoing presence of a foreign object can lead to persistent inflammation or an exaggerated immune response.
Silicone is a petroleum derivative which the body can’t break down naturally. Breast implants also contain a small amount of metals which are impurities from the manufacturing process or components used in catalysts and pigments. These include: platinum, tin, chromium, nickel, lead, arsenic, zinc, iron and aluminium. The exact composition of metals in the implant varies between manufacturers and implant models. It is thought that small amounts of silicone compounds or trace metals may “bleed” through the implant shell over time.
In Functional Medicine, we talk about the immune burden on the system as a promoter of illness. The immune system could be burdened by an accumulation of the following: low grade viruses, dental infections, toxins, stress, Long Covid, persistence of spike protein and more. In someone who has had a breast implant for years, one extra thing such as Covid or another infection could place additional strain on the immune system and potentially tip it over the edge. In autoimmunity, the immune system starts attacking one’s own tissues. This is logical if a foreign object becomes wrapped round one’s own tissues. The immune system can’t separate the two and has to attack both. That is why it is a good idea to ask a patient about their history and their family history of autoimmunity (i.e. thyroid, type1 diabetes, MS, Crohn’s ulcerative colitis etc.) before placing an implant.
Biofilms - An emerging BII Problem
One of the leading theories about what may trigger Breast Implant Illness is the role of biofilms. A biofilm is a thin, protective layer of bacteria that can attach to the surface of a breast implant and hide from both the immune system and antibiotics. Biofilms can contain bacteria, fungi (especially Candida species), archaea, sometimes viruses and other microbes trapped within the matrix. For example, Candida albicans and bacteria like Staph aureus or Pseudomonas aeruginosa are known to form mixed-species biofilms that are harder to eradicate than either organism alone. Unlike a typical infection, biofilms may not cause obvious signs such as redness, swelling or fever, but they can trigger a low grade, long term immune response.
If breast implants have a biofilm on their surface, the situation is unfortunately quite different from treating biofilms on living tissue. A biofilm is a community of microorganisms attached to a surface and enclosed in a protective matrix. Current medical advice suggests there is no reliably proven way to eradicate a mature implant-associated biofilm while leaving the implant in place.
Breast implants and lymphatic drainage
The breast have an extensive network of lymphatic vessels that drain body wastes mainly to the lymph nodes in the armpit. These play an important role in fluid balance and the immune defence against viruses, fungi, mould and bacteria. While many women with breast implants experience no lymphatic problems, surgery scar tissue (the capsule that naturally forms round an implant) or ongoing inflammation may alter local lymphatic flow in some women. This is one reason why breast health should be viewed not only from a purely cosmetic perspective but also as part of the body’s wider immune and lymphatic systems.
Diagnosing Breast Implant Illness (BII)
Breast Implant Illness is a diagnosis of exclusion and it has been reported that it may take an average of 3 years from a woman starting to think about BII and then taking action.
Routine tests may be completely normal, even in women experiencing significant symptoms.
The following conditions should be considered and excluded first:
*Chronic infections (viruses, bacteria, fungal infections, including Long Covid).
*Persistence of Covid Spike Protein in the body.
*Chronic immune suppression (T cells, lymphocytes, Natural Killer cells).
*Digestive issues - infections, autoimmunity, maldigestion, malabsorption etc.
*Dental infections and toxicity (root canals, mercury fillings, cavitations (unhealed extraction sites), titanium implants, gum disease).
*Structural issues, plus pathology detectable on MRI, CT scan etc.
*Allergies/sensitivities/poor diet.
*Autoimmunity.
*Diabetes type 2.
*Liver, kidney, heart disease.
When patients have handled the above but are still not making expected gains when doing all the right things, it may be time to start thinking about Breast Implant Disease.
Although there is no single diagnostic test for Breast Implant Illness, there are a few clues that we can pick up from a range of blood results. These could include:
*Low lymphocyte count
*Low immunoglobulins
*Positive autoimmune markers
*Raised inflammatory markers
*Hypersensitivity to silicone dioxide (MELISA test)
*Hypersensitivity to various metals, including platinum and nickel (the most common metal allergy) (MELISA test).
When should explant surgery be considered?
Over the years, doctors have wanted to help women with their body image. However, a darker side has begun to emerge with breast implants associated with a whole string of issues - metabolic, cellular, immune effects, brain fog, fatigue, joint pain, cognitive decline, mast cell activation and more. At the end of the day, we can’t alter biology - you put a foreign object into the body; it’s going to have a reaction. Doctors should be willing to educate themselves on these issues and to have a conversation with concerned patients along the lines of: “I think we’ve tried everything; we need to explore this because it could be a factor.” Already doctors in the U.S. are looking at safer alternatives to silicone implants - fat grafting - harvesting fat from one area of the body and injecting it into the breasts without autoimmune or cancer risks.
Explant surgery means removal of the implant. The decision to have breast implants removed is a personal one and should be made after careful discussion with an experienced plastic surgeon with knowledge of Breast Implant Illness. Explant surgery should be considered if there is:
*Recognised implant complication (rupture, leakage, capsular contracture, infection or Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).
*Persistent unexplained symptoms that they believe are related to their implants, particularly after other causes have been investigated.
*Symptoms that are resistant to standard protocols and repeated treatments.
If someone is going to explant surgery, they need to choose an experienced plastic surgeon familiar with Breast Implant Illness. An en bloc capsulectomy is a surgical technique in which the breast implant and surrounding capsule of scar tissue are removed together as one intact unit, without opening the capsule during removal. This may not always be technically possible or the safest option. A total capsulectomy (complete removal of the capsule) may achieve similar goals in many patients. If bacteria are present in a biofilm, they are thought to be located primarily on the implant surface or the inner lining of the capsule. Removing both implant and capsule removes the physical surfaces where those biofilms are attached.
Pre and Post Surgical Support
Anybody having surgery, especially with a general anaesthetic, would do well to get into the best physical shape they can beforehand i.e. remove sugar, gluten and casein from the diet and eat real foods with adequate protein and good fats. Nutritional support post surgery is very important with adequate protein for tissue repair as well as other tools like red light therapy, vitamin D and lymphatic therapy for tissue healing. Many women report feeling better after their explant. Others may have co-existing conditions that still need to be worked on i.e. chronic infections, dental infections, mast cell dysfunction etc. Heavy metal detox may be a part of the healing journey. But removing the implants may have removed one piece of the symptom jigsaw.
Choosing health without losing yourself
Deciding to remove breast implants can be one of the most emotionally complex health decisions a woman makes. It’s rarely just about surgery. It can touch confidence, identity, relationships, femininity, and the image a woman has built up of herself over the years.
For some women, the decision is straightforward because of pain, rupture, or another medical reason. For others, living with chronic symptoms, it can feel like an impossible choice. Do I keep the body I’m used to, or do I choose the possibility of better health?
Many women discover that they have quietly tied their self-worth to how they look - a reflection of the messages many of us receive from a young age. Our value is often measured by youth, beauty and outward appearance. Yet when health begins to decline, priorities naturally shift.
Being able to wake up with energy, think clearly, hug your children without pain, enjoy meals without fear, exercise, laugh, travel, or sleep well often becomes more meaningful than achieving a particular body shape. Health creates freedom.
After explant surgery, the body may look different but the difference does not mean it is less beautiful. A flatter chest does not diminish femininity. Look at some of our super models. A healthy small, bright eyes, genuine laughter, confidence and vitality are qualities that cannot be purchased or implanted. Many women feel that as their health improves, they carry themselves with a confidence that is deeper than appearance alone.
Healing is rarely instant. The body will change during the months after surgery. Swelling settles, tissues soften, muscles relax. Emotionally, confidence often returns gradually rather than overnight. Having positive, loving supportive family members helps enormously. If you opt for explant surgery, avoid judging your appearance in the first few weeks after surgery. Give your body the same patient you would offer a close friend.
Further reading:
*Top racing driver Danica Patrick on Youtube talking about her breast implant and explant surgery experiences and her journey back to health.
*Plastic surgeon Dr Jonathan Kanevsky in interview with Dr Mark Hyman online.
*Breast implant expert Dr Patricia Maguire - Breast Implant update series online.
*Plastic surgeon Dr Brad Storm online.
If you are concerned about any of the issue in this blog, please get in touch with the Good Health Clinic on goodhealthclinic@outlook.com to request a free 30 minute Enquiry Call or book an appointment. Please note that an Enquiry call is not a consultation but an exploratory call to see if this is a clinical approach you wish to pursue.To your very good health,
Suzanne Jeffery (Nutritional Medicine Consultant)
M.A.(Oxon), BSc.(NMed), PGCE, GNC, BSEM, MNNA, CNHC
The Good Health Clinic at The Business Centre, 2, Cattedown Road, Plymouth PL4 0EG
Tel no: 07836 552936/ Answer phone: 01752 774755
Disclaimer:
All advice given out by Suzanne Jeffery and the Good Health Clinic is for general guidance and informational purposes only. All advice relating to other health professionals’ advice is for general guidance and information purposes only. Readers are encouraged to confirm the information provided with other sources. Patients and consumers should review the information carefully with their professional health care provider. The information is not intended to replace medical advice offered by other practitioners and physicians. Suzanne Jeffery and the Good Health Clinic will not be liable for any direct, indirect, consequential, special, exemplary or other damages arising therefrom.