The Surgeon Minute

Surgeons Working to Define Breast Implant Illness

Surgeons Working to Define Breast Implant Illness

Breast implant illness is a phrase used by patients to describe an ever growing list of symptoms that some women feel are caused by their breast implants. But with no known diagnosis, there isn’t a “test” that a plastic surgeon can perform to determine whether or not this is, in fact, the case. Silicone gel breast implants are still one of the most studied medical devices in the world. This does not mean, however, that what these women are experiencing is not real.

The question for plastic surgeons is whether or not the symptoms will improve if the implants are removed. As a physician, board certified plastic surgeon Dr. Kristi Hustak’s first rule of thumb is a classic in the medical world: first, do no harm. She does not want any patient to undergo unnecessary surgery. Here are some of the steps that she is taking in her practice to further define and treat breast implant illness.

What is Breast Implant Illness?

“This is something that all of us plastic surgeons are trying to figure out,” explains Dr. Hustak. As of right now, there is not a medical diagnosis for breast implant illness. This is what makes is so difficult for plastic surgeons. Patients will sometimes come in with a two page list of symptoms that include:

  • fatigue
  • hair loss
  • headaches
  • chest pain
  • photosensitivity
  • chills
  • chronic rash
  • anxiety
  • body odor
  • sleep issues
  • brain fog
  • depression
  • neurological issues
  • hormone issues

The problem is that many of symptoms have a lot of crossover with other known and common conditions, such as:

  • peri-menopause
  • thyroid issues 
  • known autoimmune diseases 

While there are tests that can be run to determine the above, there isn’t for breast implant illness. How can something be treated without a diagnosis? 

Breast Implant Illness Woman in Pain

Anecdotal Evidence

Step one for Dr. Hustak is studying breast implant illness in her own practice. She has developed a questionnaire, along with a group of other female plastic surgeons in the country, in order to try and suss out which symptoms actually get better if the patient’s breast implants are removed. While there are quite a few patients who feel better without their implants, “there is a huge subset that don’t,”she mentions. “I want to figure out if this is a fear thing.” She is happy to take out a patient’s implants, but there is nothing worse than a patient who has a pair of breast implants that she loves who has them removed for no reason. 

The Power of Fear

Fear is an incredibly powerful emotion. Anxiety around the breasts and breast health is a very real thing. Every modern woman is brought up with the knowledge that 1 in 8 women will get breast cancer, which is incredibly scary. And for some patients, the anxiety is so overwhelming that removing the implants will probably make them feel better purely in a psychological sense. For others, time will tell as surgeons and researchers try and pin down what the cause might be, if any.

Checking a Patient's Breasts

En Bloc Capsulectomy is Not Necessary

Dr. Hustak begins every conversation with a potential breast implant illness patient by checking to make sure that tests have been run to rule out any known conditions that could be causing these symptoms, such as:

  • celiac disease
  • hormones
  • thyroid disease

Oftentimes, however, these patients have already been through a battery of inconclusive tests and they want the implants out. Dr. Hustak removes the implants and some of the scar tissue. There is a lot of misleading information online about the scar tissue, or the capsule that forms around the implant. Many believe that it must be removed “en bloc” which means in one solid piece, and then be sent out and checked for 500 different molds. Dr. Hustak is “not convinced” that this is necessary. Furthermore, sometimes performing an en bloc removal is actually dangerous for the patient. “Right now, our data is skewing towards as long the scar tissue is out one way or the other, it does not need to be en bloc,” shares Hustak.

Educating Patients is Key

Bottomline, there is really more unknown about breast implant illness than known. However, there is a very real disease called ALCL, a form of large cell lymphoma that has been linked to textured breast implants. How do you then balance the fear and the reality for patients? With every new breast augmentation patient, Dr. Hustak has a conversation about breast implant illness. She explains that plastic surgeons are trying to define it and study it, but that, currently, they don’t understand why certain women get it and others don’t. 

Dr. Hustak wants every new patient to be aware of the facts. “I am perfectly capable of making an informed decision in my own body if I have all the data,” she says. “These women are educated and they can make decisions on their own body as well.” Interestingly, while most patients are happy to talk about it, none took that information and decided to forego their breast augmentation surgery.

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