In the past year, there has been growing media attention—particularly online—surrounding the concept of “breast implant-related symptoms” after breast augmentation, which many online forums are referring to as “breast implant illness” or “breast implant syndrome”. A quick snapshot of Google trends for the term shows it has garnered significant attention in the past 6 months. Interestingly, most of these searches have been made in Australia. So what is “breast implant illness” and is it a myth? Is it just media hype and over-reporting of symptoms, or is it a legitimate medical condition?

A broad brush stroke of the Google search results presents conflicting information. For example, an article by HealthLine considers Breast Implant Illness to be a synonymous term with BIA-ALCL, which is something we have written about previously on the blog. Breast Implant-Associated Large Cell Lymphoma (BIA-ALCL) is a rare lymphoma that has historically only been associated with textured breast implants. The risk is as low as 1 in 40,000, and there have been no cited cases of BIA-ALCL in women with smooth breast implants (Dr Richardson’s implant of choice). The problem with the HealthLine article is that the term ‘breast implant illness’ has nothing to do with BIA-ALCL.  Rather, it is related to a host of symptoms that are supposedly affecting women with breast implants globally.

What is breast implant illness?

An article by the Australasian Society of Aesthetic Plastic Surgeons gives a clearer picture of the public discussion. It states breast implant illness is a non-defined, capture-all phrase used by patients with a variety of symptoms. Symptoms generally present years after their breast surgery.

There isn’t a shortage of stories in the media regarding breast implant syndrome. A news search brings up pages and pages of articles.

Discussion of the concept has definitely grown in popularity over the past year. However, it has actually been continually surfacing, fizzling out, then resurfacing again for over a decade. Even in the late 90s and early 2000s, studies were being conducted. These studies investigated the link between older generation breast implants and a list of commonly-cited symptoms.

Is breast implant illness real?

Stine (1996) conducted a comprehensive study into the phenomena. They concluded that there was no known pathophysiologic explanation for the wide range of nondescript symptoms cited by women. These symptoms included:

• Fatigue
• Muscle aches
• Concentration difficulties
• Weakness
• Numbness
• Rashes
• Digestive problems
• Complaints of fever

The author noted that none of the above symptoms were unique to women with breast implants. A study from Harvard University stated that “these symptoms are common with many other medical conditions including ageing and a host of psychiatric disorders…and the opinion surrounding this new disease is nothing more than speculation” (Sanchez-Guerrero, 2000).

Fryzek et al. (2001) also found that no distinctive grouping of symptoms has emerged from epidemiological research, They state if an atypical syndrome did exist, it is currently eluding diagnostic classification. 17 years since this article was published, and there is still a lack of robust evidence to validate any “syndrome” or standard symptoms to suggest the existence of any breast implant-related illness.

So, if there’s no current scientific evidence of “Breast Implant Illness”, then why are so many people talking about it? There are even voices in the public discussion that are so passionate about their symptoms that they have opted for breast implant removal and are advocating for others to do the same. Stine (1996) explains three potential explanations for the phenomena:

1. Firstly, those who elect to undergo breast augmentation might have learned behaviours or traits that make them more inclined to notice and report bodily changes and symptoms.

In other words, those women who have implants may be hyper-aware of changes in their body

2.  Recall or reporting bias could exist, caused by public attention aroused by media reports that might have produced exaggerated symptom reporting.

Nothing new here – the sensationalised stories on the forums and news articles can wreak havoc on the minds of women with breast implants who previously had no symptoms to report.

3. Selection bias would exist, as women with ongoing symptoms were more inclined to discuss and publicise their personal symptoms.

This one is self-explanatory – the most passionate voices are the loudest, and the proportion of women who are reporting symptoms are occupying the vanguard of the breast implant illness or breast implant syndrome discussion. This can create a very biased account of the experience of women with breast implants.

Nonetheless, there are still patients who are adamant that their symptoms are a result of their breast implants, and there are entire forums, websites, and social media communities dedicated to the fact. Dr. Mark Lee states that many of the symptoms described on these forums are general and non-specific, and are associated with a variety of different diseases (Lee in Titilius, 2018). He goes on to say that as long as your plastic surgeon abides by the 14-point plan for surgical best practice, you are likely in safe hands. As a certified plastic, reconstructive, and cosmetic surgeon with a total 28 years training and surgical experience combined, Dr. Philip Richardson adheres closely to the 14-point plan and is well-versed in best practice for plastic surgeons.

At this stage, the evidence surrounding breast implant syndrome is lacking. However, there are still a number of measures women undergoing breast surgery can take to avoid future complications post-surgery. The first is to choose a fully-certified plastic, reconstructive, and cosmetic surgeon with significant surgical experience. In our next blog post, we will be discussing in detail the difference between cosmetic surgeons and plastic surgeons, so stay in tune with our blog. Choosing a quality plastic surgeon who adheres to the 14-point plan is a pivotal aspect of avoiding post-operative complications. The type of implant used by the surgeon is an equally important consideration for patients. Dr. Richardson uses Motiva implants, which are smooth surface implants and the most advanced implant technology on the market. Their rate of capsular contracture is less than 1%. With a smooth surface, there is also no cited link to ALCL.

Conclusion

Ensuring you are vigilant with post-operative care is also pivotal to the longevity of your implants. This involves both short and long-term care. Short-term care involves closely following the post-operative instructions provided to you by your surgeon and being patient with the healing process. Long-term care involves routine ultra-sounds and reviews. BRAS clinic in Brisbane, Queensland is the only implant review clinic that exclusively offers implant review services and ultra-sound referrals with minimal out-of-pocket expenses.

So now that you know the facts, what do you think? Do you think that the scientific evidence speaks louder than the voices on the forums and in the media? Or do you think that the research falls short, particularly given the anecdotal evidence? Whichever side of the fence you sit on, there is definitely a need for further investigation of the issue, and a more balanced discussion in the mainstream media.

If you’d like to learn more about breast augmentation, or discuss any information contained in this blog post, we encourage you to contact us.