It is important to state that the majority of patients with silicone breast implants, whether inserted for cosmetic or reconstructive purposes, do not report problems.
A small percentage of patients with breast implants may report a set of symptoms, which include “brain fog” fatigue, anxiety, depression, hair loss, cracking nails and joint pain. The list of symptoms presented in this article is by no means exhaustive. The condition with these sets of symptoms is called Breast Implants Illness, however, it is not attributed to any specific type of implant or manufacturer.
In the early 1990s something of a similar nature was reported. In 1998, an in-detail investigation was carried out in the UK by the Independent Review Group (IRG). The IRG came to the conclusion, there was no evidence between silicone gel implants and any long-term illness affecting the whole body.
The diagnosis of Breast Implant Illness could be challenging as the symptoms the patients present with could be as result of other medical conditions. In some cases, they may even overlap. Unfortunately, currently, there is no set protocols for the diagnosis of Breast Implants Illness nor consensus of how to manage it.
Patients with silicone breast implants have become more aware recently of Breast Implants Illness due to hype generated on social media platforms. One group on Face Book was noted in an informative article by BAAPs (British Association of Aesthetic Plastic Surgeons) about Breast Implants Illness to have 50,000 members reporting symptoms.
One study reported on a randomly selected group of women who did not have breast implants yet had symptoms like those patients presenting with Breast Implants Illness. Currently, there is no evidence to support a direct link between silicone breast implants and Breast Implants Illness. It can take many years prior to reach a conclusion on this; however, data is still being collected with ongoing research on this subject.
The role of removing the breasts’ capsules (capsulectomies), and whether, en-bloc, total capsulectomy, or partial capsulectomy in improving the symptoms has no supporting scientific evidence to date.
The risks of capsulectomies along with the requirement of longer scars and possible breast contour irregularities when aiming to perform more radical capsulectomies must be weighed against the actual benefits such surgery has.
It is important to state that not all patients who have their silicone breast implants and breast capsules removed will report their symptoms improving.
As professionals, it is of utmost importance to us that patients presenting with the set of symptoms ascribed to Breast Implants Illness must be listened to with compassion to help us better understand the symptoms and related anxieties they may suffer.
It is also important that the care we provide as plastic surgeons is evidence based. We must offer the range of options available to our patients and any long-term implication silicone breast implants may have on our patients.
Surgery is like any other branch of medicine its foundation is to preserve our patients’ safety, safety first safety always. In order to achieve high level of governance we must listen, communicate, and manage our patients with a scientific approach and not be influenced by the social media in our decision making. Our role as doctors is to help educate our patients and help them make informed decision on what is best options to them.
