Breast Implant Illness Symptoms and Lab Test Evaluation

Breast Implant Illness refers to a constellation of symptoms that are present with patients with implants, short or long term.

Studies have existed for over a decade indicating significant reduction and or resolution in symptoms in patients that undergo implant removal that do not have documented other contributory diseases.

Further reviews are ongoing that will be essential to our increased understanding of this process and are critical to address patients concerns and help provide guidance for those with implants, and those considering augmentation mammoplasty.

Breast Implant Illness has been described as a human adjuvant disease, silicone induced human adjuvant disease, autoimmune inflammatory syndrome induced by adjuvants, and silicone implant incompatibility syndrome.

There are likely other significant and complex factors including general inflammatory response relating to capsular formation and potential biofilms, subacute inflammatory reactions, and genetic influence on materials and conditions.

These combinations and variables sound complex to understand to both patients and physicians. The expectation is that by careful collection of date, really listening to patient concerns and experiences, and further scientific evaluation, that there will be direct progress in evidence-based patient care for Breast Implant Illness.

Frequent BII Concerns and Symptoms

Surveys recently published (June 2022) reviewed the list of most frequent concerns and symptoms of Breast Implant Illness patients, using data from patients, social media groups, plastic surgeons, health care researchers, and USFDA personnel. The following list is most current and ranked in descending order of reported frequency.

Due to data demonstrating more difficulty in counseling patients regarding their condition, and documenting recovery and resolution of symptoms long term (greater than 6 months) in those patients without contributory illness, there are current suggestions as well as to evaluation and pre-operative workup prior to implant removal.

If positive results occur, this alone does not suggest that implant removal may not have significant impact on reduction in concerning symptoms. Identification of other illnesses and treatable diseases is critical, in both consultation and long-term success for health.

Suggested Blood Work Up for Suspected BII

• Full blood count
• Urea electrolytes creatinine
• Liver function tests Thyroid function
• Serum IgG, IgM
• Iron, ferritin
• Autoimmune disease markers
  • Antinuclear antibody
  • Antineutrophil cytoplasmic antibody
  • Anti-double strand DNA
  • Anti-Sjogren’s syndrome A
  • Anti-Sjogren’s syndrome B
  • Rheumatoid factor
  • Anti-ribonucleic acid protein
  • Anti Sm, antiscleroderma antibodies
  • Anti-TTG
  • CRP, C reactive protein
  • ESR, erythrocyte sedimentation rate
  • TTG, tissue transglutaminase. Ref 2

The Importance of a Clinical Exam

A comprehensive clinical exam is essential to determine additional risk factors for surgery.

Expected questions include:

• Family history
• Personal history of breast disease or issues, lumps, masses, discharge, prior mammograms or ultrasound evaluations
• Biopsy history
• Personal or family history of bleeding or clotting disorders
• History of smoking and tobacco use
• Prior surgery experience (issues or complications)
• Use of prescription medications.

Typically, general risks of implant removal are low, including bleeding and infections. However, whenever a capsulectomy is performed, and implants are removed, the result is a space that now requires healing, deposition of protein, and in those with sub muscular implants, the muscle continue to move during normal activity during healing.

Capsulectomy has been considered as an option by some surgeons. However, if the capsules are NOT removed, there is data that has been reported that the capsules can and do remain present for as long as 17 years or more.

We recommend removal of capsules with implant removal at the minimum to help restore normal anatomic considerations.

Deciding on Breast Implant Removal

Breast Implant Removal is for some a decision of timing, for some a decision of health, for some easy, and for many associated with high anxiety and concern.

As a board-certified plastic surgeon my role is to provide you specific and precise information regarding your condition, your concerns, and your expected outcome, so that together we can help guide you toward a healthy and comfortable and attractive appearance for your future.

Request a Consultation

Dr. Rudderman has over 25 years as a leading plastic & reconstructive surgeon in the Atlanta area. He listens to your concerns and goals and conducts a thorough evaluation of you health, activities, general lifestyle and family history. From the consultation evolves, trust, respect, mutual understanding, and a personalized breast implant illness treatment plan.

Contact us at 678.566.7200 to schedule a consultation in our Alpharetta or Midtown Atlanta offices.

Sources:

Understanding Breast Implant–Associated Illness: A Delphi Survey Defining Most Frequently Associated Symptoms
de Vries, Claire E. E.; Kaur, Manraj N.; Klassen, Anne F.; More
Plastic and Reconstructive Surgery. 149(6):1056e-1061e, June 2022.

Breast Implant Illness: A Way Forward
Magnusson, Mark R.; Cooter, Rod D.; Rakhorst, Hinne; More
Plastic and Reconstructive Surgery. 143(3S):74S-81S, March 2019.