Breast Implant Illness or BII, is a term and condition, which refers to symptoms and complications related to breast implants. BII can include a variety of symptoms and as a result, continues to be something that the wider medical community are endeavouring to learn more about as women with breast implants present with varying symptoms. Whilst a relatively rare condition, it is a topic which is regularly reported on inaccurately, and is often clouded in confusion and complexity making it difficult for women to sort the fact from the fiction.
Pink Hope invited Specialist Oncoplastic Breast Surgeon, Dr Samriti Sood to explain why BII is such a complex condition and to provide advice on what you can do if you’re worried about your breast implants.
You can view the recording of Dr Sood’s presentation and follow up Q&A session at this EduEvening, here.
What is Breast Implant Illness (BII)?
BII encompasses all symptoms or complications related to breast implants. There has been reported links between silicone breast implants and systemic diseases, such as autoimmune diseases, since the 1960s, however the many studies that have attempted to confirm the links have not been able to provide strong evidence due to small samples sizes, variable documentation and non-specific symptoms, making this a difficult condition to research.
A paper published in medical journals in 2019, titled “Breast Implant Illness: A Way Forward”, lists systemic symptoms associated with BII as fatigue/low energy, cognitive dysfunction (brain fog, memory loss), headaches, joint and muscle pain, hair loss, recurring infections, swollen lymph nodes and swollen glands, rashes, irritable bowel syndrome, and even problems with the thyroid and adrenals.
The article also makes reference to autoimmune diseases that have been known, albeit rarely, to be triggered by the women’s immune system in response to the implants, such as Raynauds, Hashimotos or Rheumatoid Arthritis.
Textured Implants and BIA-ALCL
Breast implants commonly come in two forms – textured or smooth.
Textured implants have, until recently, been the most commonly used, however it is now known that high-grade (textured Grade 3 and Grade 4) textured implants can, in some cases, trigger an inflammatory response in the women’s immune system resulting in an allergic reaction, an autoimmune response that may lead to the BII symptoms listed above, or the very rare lymphoma – BIA-ALCL.
Breast Implant – Associated Anaplastic large cell lymphoma (BIA-ALCL) is a very rare immune system cancer, it is important to note this is not a breast cancer.
It was first reported in 1997 and in 2016, the WHO classified it as a distinct clinical entity due to its association with breast implants, specifically textured implants. It is important to note that there are no cases of BIA-ALCL associated with smooth implants.
A woman who presents to her doctor with sudden onset swelling of one or both breasts, with no other triggering factors such as infection, will require further investigation to rule out BIA-ALCL. Another symptom can be the development of a lump or lumps in the breast, particularly around the edge of the implant, whilst other women may experience enlarged lymph nodes in one or both arm pits.
It is thought that due to the greater surface area and coarseness of a macro textured implant, a bacterial biofilm can grow, causing a low–grade infection over time. These infections are often overlooked by the woman as they don’t produce symptoms for quite some time and the women may not even know that she has a bacterial infection. Over time this infection triggers and activates the immune system to fight the infection, leading to the immune system becoming overactive, resulting in a cancer.
Macro textured implants have been recalled from sale in Australia as a result. Surgeons have introduced updated standard of care precautions before, during and after surgery and the use of smooth implants has been increased. This has led to a significant reduction in cases of BIA-ALCL and breast implant infections.
What can you do if you’re worried about your implants and your health?
If you are experiencing any of the symptoms related to BII or BIA-ALCL, or you have concerns about your general health and feel it may be related to your implants, visit your GP and you will be referred to a surgeon with experience with breast implants.
The surgeon will investigate through a physical examination and if necessary, an ultrasound. If fluid or a lump is found around the implant, a biopsy will be carried out and testing will take place to identify if there is a lymphoma or any other disease present.
It is important to remember that all of the symptoms outlined above for BII can be caused by a number of different imbalances in the body, however, if you are concerned about your breast implants you should always seek medical advice from your GP and/or your Breast Surgeon.