What the Research Actually Tells us About BII (Breast Implant Illness)
Breast Implant Illness, or BII, is a topic that comes up frequently. There is a lot of information floating around on the internet and social media, and it can be really hard to know what to make of all of it. I want to take a moment to help you sift through this topic.
What Is BII?
Some women develop nonspecific symptoms such as GI issues, brain fog, or fatigue after getting breast implants, and they attribute these symptoms to their implants. This is what is commonly referred to as breast implant illness. Some women report that these symptoms improve or resolve when their implants are removed. It is a real experience for the women who go through it, and I take those experiences seriously. At the same time, I think it's important to share what the research actually tells us.
What Does the Science Say?
The Aesthetic Surgery Education and Research Foundation (ASERF) has conducted four high-quality studies specifically on BII. Here's a brief summary of what they found:
Study 1 looked at whether the type of capsulectomy (removal of scar tissue around the implant) affected symptom improvement. It did not. Notably, 78% of patients had no capsule removed at all and still reported improvement.
What this means for patients: The capsule around the implant is not causing any symptoms, and there is no medical indication for capsule removal, or capsulectomy.
Study 2 found measurable levels of metal in some capsules, both in the BII cohort and the cohort of patients without BII, but all were well below what is considered a safe level of exposure.
What this means for patients: There is nothing IN the implants, such as heavy metals, that causes the symptoms of BII.
Study 3 examined an infectious source using next-generation DNA sequencing (NGS) and Staph antibodies. There was no difference in the type or number of symptoms, or in symptom improvement, between patients who tested positive versus negative, making an infectious cause unlikely.
What this means for patients: Implant-related infections are not a cause of BII symptoms.
Study 4 found systemic symptom improvement at one year in the BII cohort of patients who underwent implant removal, regardless of the type of capsulectomy performed.
What this means for patients: A potential nocebo effect could be contributing to this improvement. The nocebo effect is when a person experiences symptoms or side effects because they expect or fear that they will. It is the “evil twin” of the placebo effect.
What the research suggests is that there is nothing in the implants themselves that directly causes the nonspecific symptoms of BII. There were no differences in biospecimen results between the BII cohort and the cohort without BII. The current evidence points more toward a mind-body, or psychosomatic, phenomenon rather than direct causation from the implants.
So, What Does This Mean for You?
While some women do report experiencing negative symptoms after getting breast implants, the scientific research has not established a clear connection between the implants and these symptoms. I think it is important to approach this topic in a data-driven way as opposed to getting swept up by the fear-mongering that exists online about BII.
If you have questions or concerns about BII, or want to nerd out with the data a bit more, schedule a consultation so we can talk through it together in detail.
TL;DR
BII is a real and frequently discussed topic. I want you to feel informed rather than confused or scared by what you read online. The research conducted by ASERF across four studies has not found a clear biological cause tied to the implants themselves. Your questions and concerns are always welcome in my office. Let's talk.
Sources:
Glicksman C, McGuire P, Kadin M, Lawrence M, Haws M, Newby J, Ferenz S, Sung J, Wixtrom R. Impact of Capsulectomy Type on Post-Explantation Systemic Symptom Improvement: Findings From the ASERF Systemic Symptoms in Women-Biospecimen Analysis Study: Part 1. Aesthet Surg J. 2022 Jun 20;42(7):809-819. doi: 10.1093/asj/sjab417. PMID: 34915566; PMCID: PMC9208825.
Wixtrom R, Glicksman C, Kadin M, Lawrence M, Haws M, Ferenz S, Sung J, McGuire P. Heavy Metals in Breast Implant Capsules and Breast Tissue: Findings from the Systemic Symptoms in Women-Biospecimen Analysis Study: Part 2. Aesthet Surg J. 2022 Aug 24;42(9):1067-1076. doi: 10.1093/asj/sjac106. PMID: 35474526; PMCID: PMC9400612.
McGuire P, Glicksman C, Wixtrom R, Sung CJ, Hamilton R, Lawrence M, Haws M, Ferenz S, Kadin M. Microbes, Histology, Blood Analysis, Enterotoxins, and Cytokines: Findings From the ASERF Systemic Symptoms in Women-Biospecimen Analysis Study: Part 3. Aesthet Surg J. 2023 Feb 3;43(2):230-244. doi: 10.1093/asj/sjac225. PMID: 35980942; PMCID: PMC9896138.
Glicksman C, McGuire P, Kadin M, Barnes K, Wixtrom R, Lawrence M, Haws M, Ferenz S, Sung CJ, Hamilton RG, Faasse K. Longevity of Post-Explantation Systemic Symptom Improvement and Potential Etiologies: Findings From the ASERF Systemic Symptoms in Women–Biospecimen Analysis Study: Part 4. Aesthetic Surgery Journal, 2023; Vol 43(10):1194–1204. Oxford University Press on behalf of The Aesthetic Society.
