The effect of explantation on systemic disease symptoms and quality of life in patients with breast implant illness: a prospective cohort study

Abstract

Silicone breast implants (SBIs) have been subject to scientific scrutiny since the 1960’s because of their potential link with systemic disease symptoms. Breast implant illness (BII) is a cluster of over 56 (systemic) symptoms attributed by patients to their SBIs. BII remains an unofficial medical diagnosis, although its symptoms include but are not limited to the clinical manifestations of autoimmune/inflammatory syndrome induced by adjuvants (ASIA). The aim of this study was to prospectively analyse the effect of explantation on clinical manifestations of ASIA/BII symptoms, as well as to compare (breast-surgery specific) QoL in patients pre- and postoperatively while recording relevant perioperative/patient data. A prospective cohort study was conducted on 140 patients consulting a single surgeon for explantation of SBIs at a single clinic from 2019 to 2021 via their general practitioner, a medical specialist or self-referral. Of all patients, medical (implant) history, lifestyle factors and biometric data were obtained. Patients filled out a novel ASIA/BII symptom-survey termed the ASIA-scale, three domains of the SF-36 and the augmentation module of the BREAST-Q before and four months after the operation. A total of 109 patients completed both the pre- and postoperative survey with a mean follow-up duration of 205 days. There was a significant decrease in all individual symptom scores as well as ASIA-scale summary scores after explantation (p < .001). All SF-36 subdomains showed significant improvement postoperatively (p < .001). The BREAST-Q subdomain ‘satisfaction with breasts’ improved significantly after explantation (p = .036). No statistically significant association was found between any clinical parameters (such as age, capsulectomy, rupture etc.) and the recovery of symptom scores. This is the largest prospective cohort study on SBI explantation to date showing significant improvement of the most common systemic complaints in SBI patients as well as improvement of satisfaction with breasts and overall quality of life.

Longevity of Post-Explantation Systemic Symptom Improvement and Potential Etiologies: Findings From the ASERF Systemic Symptoms in Women–Biospecimen Analysis Study: Part 4

“…Only 7.9% of their study patients underwent a total capsulectomy, 15% had a partial capsulectomy, and 78% had no capsule removed. 10 Their data reinforce that in the absence of other indications for capsulectomy, such as capsular contracture, rupture, a malignancy, or evaluation for malignancy, a total capsulectomy is not indicated.…”

Biofilm-derived oxylipin 10-HOME mediated immune response in women with breast implants

“…While formal definitions leave much to be desired, approximately 50 possible systemic subjective symptoms are attributable to BII, including fatigue, anxiety, and chronic pain (3). In certain cases, objective signs of the disease can manifest, including endocrine, peripheral nervous system, and somatic dysfunctions (4,5).…”

Breast Implant Illness: A Cohort Study

“…Breast implant illness is a clinical disease defined by a constellation of symptoms patients experience as a result of their breast implants. As the disease has become more popular in the media, widespread conversations have characterized this illness as a cluster of over 50 symptoms associated with breast implants [ 7 ]. It is unknown whether or not this is secondary to a direct pathological process or perceived connection to implant placement.…”