What is breast implant illness (BII)? Common symptoms and signs to look out for in 2024

According to the American Society of Plastic Surgeons, around 300,000 people in the United States have had breast augmentation in recent years [1]. As this cosmetic procedure becomes more popular, we’re learning about a concerning health issue called breast implant illness (BII).

BII describes symptoms that some people with breast implants experience, believing their implants are the cause. We’ll go over the common symptoms of breast implant illness, its prevalence, associated risks, and things to consider if you have or want to get implants.

How common is BII in 2024?

It’s hard to know exactly how many people have BII because doctors don’t have a clear way to diagnose it yet. However, a growing number of women with breast implants are reporting symptoms they attribute to their implants.

A 2022 study found that out of 100 patients who had their breast implants removed due to unexplained symptoms, 89% reported feeling way better after explant surgery [2].

While this suggests a potential link between breast implants and certain health problems, we need more research to establish the true prevalence and causes of BII.

Common symptoms and signs of breast implant illness - Associated risks

BII can cause a wide range of symptoms that affect different parts of the body.

Some of the most common signs are:

1. Always feeling tired even after resting

2. Trouble thinking, remembering things, or focusing

3. Pain and stiffness in joints and muscles

4. Skin problems like rashes, dryness, or sensitivity

5. Stomach issues like bloating, nausea, or diarrhea

6. Hormonal changes like irregular periods or weight gain

7. Hair falling out or thinning

8. Symptoms that seem like autoimmune diseases

Musculoskeletal symptoms

Some patients with breast implant illness have musculoskeletal problems that can make daily life hard, such as:

Joint pain

BII patients may have aching, stiffness, and trouble moving their joints like their knees, hips, shoulders, and hands. The pain can last a long time and might not get better with normal pain medication.

Muscle weakness

Some people with BII feel weak and have difficulty doing things they could do before. This weakness can affect different body parts and might come with a heavy or tired-feeling in the muscles.

Muscle Stiffness 

Along with weakness, BII patients may feel tightness and have trouble moving their muscles. This makes it uncomfortable for them to do physical activities.

Cognitive and neurological symptoms

BII can also negatively impact how the brain works in the following ways:

Anxiety

People with BII might worry more, feel restless, and have trouble relaxing. This anxiety could be because they’re worried about their health, how their symptoms affect their daily life, or because they don’t know what’s causing them to feel a certain way.

Depression

BII patients may feel sad, hopeless, and lose interest in things they used to enjoy. The physical and emotional stress of BII can worsen depression symptoms.

Brain fog

Brain fog is when someone feels mentally confused, sluggish, and has trouble thinking clearly. Some women with implants say they feel like they’re in a haze and can’t find the right words or remember things.

Fatigue

Fatigue isn’t just normal tiredness. It can be so severe that it’s hard to do daily activities and tasks. Resting often doesn’t help, causing a diminished quality of life.

Memory loss

Some people with BII can’t remember recent events, conversations, or information they’ve learned. This memory loss can be frustrating and might contribute to anxiety and depression.

Concentration issues

BII patients may experience a decreased ability to focus on tasks, follow conversations, or do things that need their full attention. This can affect their work, relationships, and overall functioning.

Systemic symptoms

BII can cause symptoms that affect organs and functions throughout the body:

Autoimmune condition symptoms

Some people with BII have symptoms similar to autoimmune disorders like rheumatoid arthritis. Examples include joint pain, skin rashes, dry eyes and mouth, and hair loss. 

Chronic pain

Mild to severe chronic pain can affect different body parts including the chest, breasts, back, and joints.

Dry eyes 

Women may experience a gritty or burning sensation in their eyes after getting breast implants. Redness, irritation, and difficulty wearing contact lenses are also frequent symptoms. Dryness may require eyedrops or other treatments to manage.

Low vision

Some women with BII report changes in their eyesight, such as blurred or double vision, sensitivity to light, and difficulty seeing at night. These vision changes may be related to dry eyes or other systemic effects of BII.

Hair loss

Hair loss looks different for every BII patient. But it could involve shedding, thinning hair, or bald patches. This can be distressing and may add to feelings of self-consciousness or anxiety.

Skin problems

BII can cause skin issues like rashes, dryness, itching, and sensitivity. Some people may develop hives, eczema, or psoriasis-like symptoms.

Testing for breast implant illness

Right now, there’s no diagnostic test for BII. But doctors can use different methods to evaluate symptoms and rule out other possible causes.

The process of testing for breast implant illness may involve the following steps:

Step 1: Medical history and symptom review

Your doctor will review your medical history and the symptoms you share. They’ll ask you when they started, how long they’ve lasted, how bad they are, and anything that might trigger them (or make them better).

Step 2: Physical examination

A physical exam will help your doctor see any visible signs of breast implant illness, like skin changes, swollen joints, or changes in the breasts. They’ll check your overall health and look for signs of other conditions that could be causing the symptoms.

Step 3: Blood tests

Blood tests will help rule out other health problems that might cause similar symptoms, like autoimmune diseases, thyroid problems, or vitamin deficiencies. There isn’t a specific blood test for BII. But these tests can give vital clues about overall health and things that might contribute to the symptoms.

Step 4: Imaging tests

Imaging tests, like mammograms, ultrasounds, or MRIs, can check the condition of the breast implants and the tissues around them. These tests will help your doctor identify ruptures, leaks, or other problems that could cause BII symptoms.

Step 5: Allergy tests

Your doctor may suggest allergy tests to see if you’re sensitive to the materials used in breast implants. Some people are allergic to silicone or other chemicals without knowing it.

Step 6: Ruling out other conditions

An important part of figuring out if someone has BII is making sure it’s not something else causing similar symptoms. This might mean more tests, seeing specialists, or a process of elimination based on your specific symptoms and medical history.

Do specific types of breast implants lead to higher potential of BII?

Right now, there isn’t clear proof that saline breast implants or silicone breast implants make it more likely to get BII. Researchers have speculated that BII may be caused by bacteria growing on the implant or by the immune system reacting to the implant [3]. But we need more research to understand if certain types of implants play a role in causing BII.

Breast implant safety monitoring

It’s essential to check on breast implants regularly to find problems early.

Key monitoring measures for breast implant safety include:

• Regular self-examinations: Check your breasts every day for any changes in how they look, feel, or if they’re even

• Routine check-ups with your surgeon: Schedule regular appointments with your plastic surgeon to check your implants and discuss any concerns

• Mammograms and ultrasounds: Get regular mammograms and ultrasounds as recommended by your doctor to spot changes in breast tissue or implant problems

• MRI scans: Consider getting periodic MRI scans, especially if you have silicone implants, to find any silent ruptures or leaks

• Reporting symptoms: Tell your doctor right away about anything new or worsening symptoms so they can treat them before they get worse

• Tracking symptoms: Keep a record of any symptoms you have, including when they started, how long they last, and how bad they are, to help doctors find patterns or triggers

• Blood tests: Get regular blood tests to keep an eye on your overall health and rule out other conditions that might cause similar symptoms

Examples of breast implant issues - Photos 

Breast implant problems can show up in different ways, affecting how the breasts look and feel, and the patient’s overall health.

Two common examples of breast implant issues are:

1. Capsular contracture

Scar tissue around the implant gets hard and squeezes the implant. This makes the breast feel firm and painful, and look distorted. In severe cases, the breast may look misshapen or pulled upward.

2. Implant rupture

The outer shell of the implant tears or gets a hole, letting the filling material (silicone gel or saline) leak into the tissue around it. With silicone implants, you may not notice rupture without imaging tests. In contrast, saline ruptures often cause the breast to visibly deflate.

Source: ResearchGate

Considerations before getting breast implants

Before deciding to get breast implants, think carefully about these factors to make an informed choice:

Understand the risks

Getting breast implants is generally safe when you choose an experienced surgeon. But all surgeries come with possible risks, which you should know about. Examples include capsular contracture, rupture, infection, and BII.

Consider the costs

Breast implant surgery and related expenses can be a lot. Think about the cost of the initial surgery and costs for monitoring, maintenance, and revision surgeries (if needed) in the future.

Evaluate the long-term implications

Breast implants may need replacement or removal at some point. Consider the long-term effects of having implants, including the possibility of needing more surgeries in the future (and how that might impact your health and lifestyle).

Research the different types of implants

Learn about the various types of breast implants available, such as saline, silicone gel, and structured implants. Talk to your surgeon about the pros and cons of each to figure out which option is best for your needs and preferences.

Prepare for post-implant changes

Your breasts may look and feel different after getting implants. Some changes may go away after a while, while others may be permanent.

Plan for monitoring

Plan to check on your breast implants, including self-exams, routine check-ups with your surgeon, and imaging tests as recommended. Proper monitoring helps catch problems early and ensure you have the best possible long-term results.

Report any abnormal changes

Be ready to tell your doctor about any new or worrying symptoms like pain, swelling, hardening, or changes in how your breasts look.

Be informed about BIA-ALCL

Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare but serious complication that has been linked to certain types of textured breast implants [4]. Ask your surgeon about this risk and know the signs to look for.

Consider breast implant illness (BII)

Be aware of the possibility of BII and the symptoms that come with it. If you have a personal or family history of autoimmune disorders or are worried about how implants might affect your health, review your concerns with your doctor before committing to the surgery.

Sources:

1. Perk up for spring: Why breast lifts are getting bigger than implants, American Society of Plastic Surgeons

2. Breast implant illness: Treatment using total capsulectomy and implant removal, National Library of Medicine

3. Breast implant illness, Cleveland Clinic

4. Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), American Society of Plastic Surgeons