Is breast implant illness real?

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If you have breast implants or are considering them, then you have no doubt come across the term ‘breast implant related illness’.
Vocal groups have formed online claiming that breast implants are responsible for a number of physical symptoms in the recipient including unexplained weight gain, lethargy, sudden food intolerances and allergies, lyme disease, fybromyalgia, anxiety, depression and more.

With such an array of claimed symptoms and increasing media attention on the proposed illness, Cosmetic Journey sat down with Renowned Plastic Surgeon and President of the Australian Society of Plastic Surgeons, Professor Mark Ashton to help separate fact from fiction.

Is breast implant illness real?

Whilst patients with implants do develop rheumatoid arthritis, scleroderma, polymyalgia rheumatica, Sjogren’s disease, hair loss and chronic fatigue, there is no scientific evidence at all that this is related to their breast implants.

Numerous studies conducted both within Australia, America and Europe have directly compared populations of female patients with and without breast implants and have found that the incidents of rheumatoid arthritis and other illnesses associated with breast implant illness are exactly the same in the cohort of patients with implants and those without.

 Should women have their implants removed?

As there is no evidence of any association at all between connective tissue disease, chronic fatigue, polymyalgia rheumatica or alopecia and implants, patients do not need to have their implants removed.

Is saline safer than silicone?

The silicone within a silicone breast implant is contained within a silicone polymer outside casing.  This silicone polymer outside casing is exactly the same whether the internal filling is saline or silicone and hence it makes no sense to choose saline or silicone if one is concerned about breast implant illness. 

The newer implants are composed of a cohesive or form stable gel in which the silicone chains are cross linked to provide a silicone which has a gelatinous or jelly baby type consistency.  The silicone filling in these implants, even when the implant is completely cut in half, does not spill out in to the surrounding tissues and remains confined to the implant casing.

Can we mitigate the risks of future complications?

 The main complications of breast implants would appear to be related to:

  1. The texturing or the roughness of the outside coating of the implant
  2. The method by which the implant is inserted and whether any bacterial contamination of the implant occurs at the time of insertion
  3. The genetic predisposition of the patient to scarring and tumour formation

It would appear that the most significant complications and risks (that is anaplastic large cell lymphoma and capsular contracture) are directly related to bacterial contamination of the implant at the time of insertion, and hence patients should choose a surgeon which follows the 14 point plan, (see attached) uses a Keller funnel and an aseptic technique within a licenced regulated facility to ensure the chances of contamination are minimised. 

Textured implants, particularly those of a grade 3 or grade 4 texturing such as a polyurethane or biocell texturing have a lower incidence of capsular contracture but their texturing predisposes them to a significantly increased risk anaplastic large cell lymphoma.  The current risk for polyurethane implants is 1:2300 and biocell texturing of 1:3600. 

In comparison, a microtextured implant such as the Siltext texturing is associated with an implant risk of 1:86500.  Smooth implants have a zero incidence of anaplastic large cell lymphoma but a significant risk of capsular contracture, particularly when placed upon the muscle and this can be as high as 10%.

The answer to the questions therefore, is for you to have a clear discussion with your surgeon, so that you can accurately assess which is the right implant choice for you.

Cosmetic Journey would like to thank Professor Mark Ashton, specialist Cosmetic Plastic Surgeon for his input into this blog post.

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