Self-Reported Health Complaints in Women Undergoing Explantation of Breast Implants

Abstract

Background Concerns about the safety of silicone breast implants have existed for years, but a causal relationship between systemic complaints and SBI has not been proven. Nevertheless, women are worried and even request explantation. Objectives This study aimed to review the explantation procedures performed, focusing on patient-reported symptoms preoperatively, the effect of explantation, and the effect of breast reconstruction on these symptoms. Methods A retrospective chart review was performed for patients who had undergone explantation between 2010 and 2020 at Maastricht University Medical Center. Patients excluded were those who had undergone tissue expander (TE) removal, TE to implant exchange, and direct implant exchange. Results More than half of the patients undergoing explantation reported complaints, mostly pain. Some 15% reported suggested implant-related systemic complaints. Breast implant illness (BII) was found to be the fifth most common indication for explantation (11.2%). A history of either allergies or implant rupture resulted in higher odds ratios of having BII (OR=2.1 and 2.1, respectively). Subjective improvement of BII after explantation was reported in about 60%. Conclusions A relatively low prevalence of suggested BII exists among women undergoing explantation; one in nine procedures was performed for this reason. Allergy and implant rupture may increase the likelihood of having BII. About 60% of BII patients experienced an improvement in their complaints after implant removal. Autologous breast reconstruction appears a good alternative. Prospective studies into health complaints and quality of life should be performed to confirm the effectiveness of explantation as a therapy for BII.

“Exploring the Patient Narrative for Breast Implant Illness: A 10-Year Review of the FDA MAUDE Database”

“…Interestingly, cluster A was the most consistent with the majority of the reported breast implant illness symptoms in our study and in the existing literature. 9,10 Although specific conclusions cannot be drawn from the two clusters, their existence could be telling in Plastic and Reconstructive Surgery • December 2022 large-scale prospective trials when more detailed knowledge of breast implant illness emerges. Despite their reintroduction to the market in 2006, additional secondary analysis of the U.S. Food and Drug Administration's postapproval studies on nearly 100,000 women with breast implants demonstrated associations between silicone implants and increased rates of autoimmune issues and systemic harms.…”

Breast-related and body-related quality of life following autologous breast reconstruction is superior to implant-based breast reconstruction - A long-term follow-up study

“…Removal of the implants improves health complaints in half of the patients [ 35 ]. A tertiary ABR could offer a solution for these women [ 36 ].…”

Neuroimaging in Breast Implant Illness: An fMRI Pilot Study

“…Not only local pain to the chest, as in capsular contracture, but also widespread pain, as in fibromyalgia, has been reported in relation to breast implants. 1 , 9 We found that both pain intensity and pain-related disability measured with the CPGS were significantly higher in BII patients than in controls. Previous MRI studies have led to the understanding that chronic pain patients display brain alterations regarding brain function and structure.…”

“…There is no objective method to assess the harmfulness of SBIs and therefore no targeted therapy is available, except the permanent removal of the implants. 9 In the majority of cases, this treatment is not reimbursed by health insurance, as a result of which patients do not receive the desired help and do not feel taken seriously. On the other hand, women are at risk of undergoing unjustified medical interventions, which can have both physical and psychological consequences.…”