Women consider getting breast implants for many reasons. In addition to being an important part of breast reconstruction surgeries, it is also one of the most popular cosmetic surgeries. In 2018 alone, 313,735 women chose to undergo breast augmentation surgery (1). Unfortunately, thousands of women now live with systemic illnesses and health problems that they believe are related to their breast implants.
It is so common that patients have developed a name for these types of conditions, Breast Implant Illness (BII). Many doctors and health officials claim that there is no proof of a link between the implants and most conditions that women believe result from their implants. Does this mean that there truly is no connection?
What is Breast Implant Illness (BII)?
Breast Implant Illness is a term used to describe a range of autoimmune symptoms that are believed to be caused by women’s breast implants. It is not currently an official medical diagnosis. This is partly due to the fact that a woman with BII can experience a wide variety of symptoms that could lead to a diagnosis of multiple autoimmune disorders such as Rheumatoid Arthritis, Scleroderma, Lupus, and Polymyositis or Dermatomyositis. The symptoms rarely fall neatly under one specific autoimmune disorder. Sometimes, autoimmune disorder symptoms appear within a year of receiving the implants but more often it can take years for the symptoms to become severe enough for a woman to seek medical treatment. Commonly reported symptoms include:
Anxiety
Chest pain
Chronic fatigue
Cognitive impairment, brain fog, memory loss
Depression
Discoloration of hands or feet
Dry skin and/or hair
Hair loss
Headaches
Hormonal Issues
Inflammation
Joint pain
Migraines
Muscle pain, myalgias
Numbness or tingling in upper and lower limbs
Rashes
Recurring infections
Sensitivity to light
Shortness of breath
Sleep Disturbances
Vertigo
If so many women believe breast implants cause BII, why are they FDA approved? Doesn’t that mean they are safe?
In determining the safety of breast implants, the FDA relied on a variety of studies that had major flaws in the way they were conducted or were never completed. Many of the clinical trials only followed women for a few months or years after they received implants. Since autoimmune disorders take time to develop enough to cause a woman to seek help, long-term studies were needed to make an accurate judgment on the safety of breast implants. The FDA claims that they have not detected an association between silicone gel-filled breast implants and connective tissue disease, breast cancer, or reproductive problems but also states that
“In order to rule out these and other complications, studies would need to be larger and longer than these conducted so far.”
Many of the studies only included women who were hospitalized for a condition, and a few included women who were officially diagnosed. This is problematic because very few people with autoimmune disorders are hospitalized specifically for the disorder. Additionally, since the studies were short term, even those that included women with an official diagnosis would not be able to accurately show the risk, since it often takes years to reach a diagnosis for an autoimmune disorder. The studies also excluded women who had a previous history of autoimmune diseases, so it is impossible to know the effect of a breast implant on the health of a woman with an existing autoimmune disease.
If you would like to more deeply research the information yourself, Diana Zuckerman and Varuna Srinivasan of the National Center for Health Research created an in-depth review called “Breast Implant Illnesses: What’s the Evidence?” in which they discuss whether the data proves that BII exists, and explain the flaws in the studies presented to the FDA. They include links to the studies that the FDA relied upon in making their decision to approve breast implants. You can also look into the information provided by the FDA regarding the reports, research, and materials used in determining the safety of breast implants.
Does the research prove BII exists?
A 2017 study by Jan Cohen Tervaert, et. al. discussed recent findings which show that patients with silicone breast implants may be more likely to have autoimmune/inflammatory syndrome by adjuvants (ASIA), allergies, autoimmune diseases, immune deficiencies, and lymphomas. They concluded that “Silicones can migrate from the implant through the body and can induce a chronic inflammatory process (2).”
A 2018 study by Abdulla Watad, et. al. analyzed the link between silicone breast implants and autoimmune disorders. They found that silicone breast implants seem to be associated with a higher likelihood of being diagnosed with an autoimmune or rheumatic disorder (3). Sjögren’s syndrome, systemic sclerosis (scleroderma), and sarcoidosis were the disorders most highly associated with silicone breast implants. Common symptoms of Sjögren’s syndrome are dry mouth and eyes but it can also affect your joints, lungs, kidneys, blood vessels, digestive organs, and nerves. Scleroderma causes your body to produce too much collagen, which may cause many symptoms including thickening skin, hair loss, and joint pain. Sarcoidosis most often causes a persistent dry cough, fatigue, shortness of breath, and painful joints.
Other recent studies, including the largest study of long-term safety for patients with breast implants conducted by researchers at The University of Texas MD Anderson Cancer Center, support the idea that silicone breast implants cause autoimmune diseases and symptoms. However, there is hope for women with BII. Around 70% of women who have their breast implants removed gain a significant reduction in their symptoms.
Other breast implant-related risks.
BII is not the only possible risk related to breast implants. The FDA lists 26 possible complications of breast implant surgery, including rupture, infection, and necrosis. They explain that breast implants are not meant to last a lifetime and, “the longer you have breast implants, the more likely it is that complications will occur and you will need to have them removed.” They recommend that people with silicone implants have an MRI every two years to check for rupture, and also briefly mention the need for more research to determine whether there is an association between autoimmune connective tissue diseases or BII and breast implants.
A major health risk related to breast implants is a type of cancer called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). This type of cancer is a cancer of the immune system and develops in women who have had breast implants. In fact, the risk is so high with certain types of implants that earlier this year the FDA requested that one company, Allergan, voluntarily recall their textured breast implants. Worldwide, there were 573 cases of BIA-ALCL and 481 of the patients had Allergan breast implants at the time of diagnosis.
How can that high of a percentage of women with BIA-ALCL develop this cancer from one company’s product if it is being appropriately tested before reaching the market? Of further concern, as Diana Zuckerman and Varuna Srinivasan stated, “If implants can cause cancer of the immune system, does that mean implants can cause other immune disorders?” The evidence is mounting to prove that breast implants can indeed cause immune disorders and cancer.
For many women, the benefits outweigh the possible consequences of breast implants. It is an intensely personal choice but, when it comes to your health, we want to help you be aware of the risks so you can make an informed decision. If you have breast implants and believe that you may be affected by breast implant illness or any of the other complications, we are here to help.
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Jonathan Vellinga, M.D. is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.
Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.
info@tcimedicine.com
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1. 2018 Complete Plastic Surgery Statistics Report, American Society of Plastic Surgeons.
2. Cohen Tervaert, J., Colaris, M., & Van Der Hulst, R. (2017). Silicone Breast Implants and Autoimmune Rheumatic Diseases: Myth or Reality. Current Opinion in Rheumatology, 29 (4), 348-354. doi:10.1097/BOR.0000000000000391
3. Abdulla Watad, Vered Rosenberg, Shmuel Tiosano, Jan Willem Cohen Tervaert, Yarden Yavne, Yehuda Shoenfeld, Varda Shalev, Gabriel Chodick, Howard Amital. Silicone breast implants and the risk of autoimmune/rheumatic disorders: a real-world analysis, International Journal of Epidemiology, Volume 47, Issue 6, December 2018, Pages 1846–1854, https://doi.org/10.1093/ije/dyy217
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