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Breast Implant Illness
Posted by Laurence Weider on February 10, 2020
Although it is not a medical diagnosis with a clear-cut cause and effect relationship, the term Breast Implant Illness is discussed more and more frequently among women with breast implants and their surgeons. Currently there is no medical study that clearly shows a link between breast implants and this group of symptoms. Nonetheless, many women have experienced relief after treatment with capsulectomy and implant removal, sometimes called En Bloc Capsulectomy. Many of these women have had extensive testing done but are unable to find a cause for their symptoms. Breast Implant Illness comprises a constellation of symptoms in women with breast implants including the following partial list:
- Brain Fog
- Memory Loss
- Hair Loss
- Dry skin
- Irritable Bowel Syndrome
- Swollen Glands
- Autoimmune diseases
- Anxiety and Depression
Although there is no test to determine if a woman’s breast implants or the capsules that surround them are the cause of any of these illnesses, Dr. Weider feels that it is important to listen to these concerns and to take them very seriously. After a thorough discussion of the patient’s implant history and her symptoms as well as any prior testing, Dr. Weider will formulate a care plan. Often times, this involves removal of the implants inside the breast implant capsules. A breast lift may also be recommended. It is important to note that Dr. Weider and his staff make no guarantees as to the effectiveness of capsulectomy with implant removal in alleviating any of the symptoms that are afflicting the patient. Nonetheless, in our practice we have seen significant improvement in many of our patients who have undergone implant removal with capsulectomy.
Some key terms:
Implant Capsule: This is the scar tissue that forms around a breast implant. It can be thin and wispy or thickened and fibrous. A small percentage of women who undergo breast implant surgery develop capsular contractures. This is a condition where over time the implant capsule becomes thick and squeezes the implant. It can be detected on examination and results in a firm immobile implant that can cause discomfort if it is severe. Many of our patients who seek out capsulectomy with implant removal for Breast Implant Illness do not have capsular contractures.
En bloc Capsulectomy: En Bloc means “all together” or “as one.” So an En Bloc capsulectomy entails removing the entire capsule with the untouched implant still inside of it. However, in surgical terminology, En Bloc means removing a tumor with surrounding normal tissue. Therefore, I prefer the term En Masse which means “as a whole”. The potential advantage is that if a silicone implant has leaked within the capsule, it can spill silicone gel. An En Masse capsulectomy provides a way for the surgeon to remove the implant and the capsule with little if any spread of the silicone gel or any other contaminants into the adjacent uninvolved tissues. However, performing an En Bloc or En Masse capsulectomy often means accepting a longer scar, because a larger incision is necessary to remove the untouched implant within the intact implant capsule. In addition, implants that are in a pocket below the muscle (submuscular) develop a capsule that is often stuck to the surface of the ribs. Removing the capsule in this fashion can lead to more post-operative pain, a higher risk of complications and a longer recovery period. During your consultation, Dr. Weider will inform you of the potential benefits and risks associated with an En Masse Capsulectomy. Based on your particular situation, he will help to formulate a care plan that works best for you
Total Capsulectomy: A total capsulectomy differs from an En Bloc or En Masse capsulectomy in that at some point during the procedure, the implant is removed from the capsule in order to facilitate the removal of the remainder of the capsule. In other words, in some circumstances such as in the case of the removal of a saline implant, it may make sense to remove the implant before the entire capsule is removed. This often allows for a shorter scar. In situations where this may be a preferable option, this will be discussed with the patient at the time of consultation so that the patient is fully informed prior to surgery.
What we offer:
Dr. Weider and his team will listen carefully to your symptoms and concerns and will formulate a plan in conjunction with you. In general, implant removal for symptoms consistent with Breast Implant Illness includes:
- En Bloc Capsulectomy (when possible)
- Pathological Evaluation when indicated
- Testing for BIA-ALCL when indicated
- Muscle repair when indicated
- Return of your implants to you if desired
- Breast Lift: this is an optional, additional procedure that is sometimes indicated for a superior cosmetic result
If you are interested in discussing options to address Breast Implant Illness, please give Weider Plastic Surgery a call at (972) 566-8444.
Dr. Weider, a native of Southern California, is a Board-Certified Plastic Surgeon who has maintained a private practice in Dallas, TX since 1999. After attending Stanford University, he obtained his medical degree (M.D.) from Baylor College of Medicine in Houston. He then completed a one year surgical internship in Los Angeles at Harbor-UCLA Medical Center, followed by a four year general surgery residency in Dallas at Methodist Medical Center, and a two year plastic surgery fellowship in Cleveland at Case Western Reserve University.