"Doc, Could My Implants Be Making Me Sick?"

By far one of the most controversial topics in the history of Plastic Surgery. In a few lines, I would like to share my experience as a Plastic Surgeon.

Perhaps more than one of you have read or heard from someone who has been mysteriously experiencing symptoms such as fatigue, depression, anxiety, chest pain, weakness, joint pain, hair loss, etc. and whose suspicion is IMPLANT-RELATED DISEASE (Breast Implant Illness or B.I.I.) or on some other occasions referred to as ASIA (Autoimmune / inflammatory Syndrome Induced by Adjuvants).

You may be here because you are thinking of getting implants, you have a couple of implants in your body, you are already thinking of removing them for some reason, or just out of curiosity. We are going to break it down as best as possible so that it is a digestible subject and in advance, I put myself at your disposal to solve your doubts and guide you on the best path in making whatever your decision is.

The truth is that there are still many loose pieces on the subject, starting with whether it is really the implants that cause this "new" disease. But what is clear to us is that every day more people come to the office referring to these same symptoms that can be caused by a myriad of causes, including emotional and hormonal imbalances, such as menopause, postpartum, thyroid problems, and autoimmune diseases. and up to the very quarantine for Covid-19.

Here we enter the dilemma: what came first, the chicken or the egg?

"Doc, What If These Symptoms Are Real? Sounds Like A Story..."

It is impossible to ignore, disapprove, or minimize the symptoms that patients refer to in the consultation, unfortunately, it is not yet scientifically possible to establish a direct link between the symptoms and the implants. There is no diagnostic test! I understand that many of us would like an imaging or blood study to be able to reveal to us if indeed what we are experiencing is related to implants, or even to know if from the microscope pathologists could find some particular characteristics that would confirm the diagnosis; however, work continues on it.

Here we are faced with a reality, SOMETHING is causing it and we have to do something to ATTEMPT at least to IMPROVE their symptoms and with it their QUALITY of life.

It must be taken into account that 80% of the cases related to implants are for cosmetic purposes, and 20% of the reconstructive type, mostly after having undergone a mastectomy (removing the mammary gland due to some type of cancer or predisposition high for it).

Also that there are multiple brands, types of implants, round, anatomical, filled with saline solution, silicone gel, with smooth coverage, advanced smooth, microtextured, polyethylene and it has not yet been possible to demonstrate or attribute to a type, content, brand or particular model.

"How Common Is It?"

Well, at least 3% of women in Mexico have breast implants, and each year around 250,000 breast augmentation surgeries are performed in Mexico, but the little record is had on the statistics of Implant-Related Disease in Mexico and the world, both due to the wide spectrum of symptoms and the lack of a diagnostic test, but it is estimated that it can be a ratio of 1 in 2,000 to 1 in 86,000. Personally, I receive at least a couple of patients a month who check at least 5 out of the 10 on the list of most frequent symptoms.

"How Do I Know? What Are These Symptoms?"

• Fatigue

• Brain fog/confusion (concentration and memory problems)

• Articulations pain

• Anxiety

• Hair loss

• Depression / suicidal thoughts

• Rash (redness/pimples on the skin)

• Autoimmune diseases

• Inflammation

• Weight problems

• Changes in sensitivity/tingling in arms

• Dry mouth and eyes

• Sleep disturbances

• Headaches
  
  

"Can It Be Prevented Or Know If I Have Any Predisposition?"

There is really no medication or diagnostic or therapeutic means by which we can prevent the appearance of these symptoms or know if you have any predisposition for the disease itself, the only way is not to be exposed to implants.

"I Have Heard That Only "Only Certain Plastic Surgeons" Know How To Treat The Area"

Nowadays colleagues love to market themselves and invent very particular terms to position themselves in a certain market, and suddenly I read in Facebook groups, as well as other platforms that advertise themselves as "the only ones", "the specials", "the unmatched ”. But to tell the truth, EVERY WELL-TRAINED Reconstructive and Aesthetic Plastic Surgeon and in CONTINUOUS UPDATING, is trained to perform the EXPLANT procedure, which consists of removing the Block Implants, that is, with everything and the capsule that surrounds them, it is obviously a hard job, It must be very precise and many times for convenience or ignorance some decide only to remove a part of the capsule, but it is necessary to carry out the explant completely so that in reality what we suppose is causing the symptoms is finally outside the body, a procedure that is carried out without pain using an anesthetic block.

Along with this come maneuvers such as placing drains so that the inflammatory fluid can flow and some postsurgical bleeding that is considered essential. As well as the need on many occasions to reconstruct the breast tissue, to give it a better location and aesthetics, after having suffered inherent modifications of age, weight loss, breastfeeding, and the volume of implants to be removed. Sometimes there are possibilities of making some flaps or fat grafts, which could give a little more volume to the treated region, to try to compensate and harmoniously improve breast aesthetics.

Changing the location implants, choosing another brand, reducing the volume, choosing another surface and other changes would not have inference in the remission of symptoms. So it is not a treatment option.

"Is It The Same As Capsular Contracture?"

No. When we create a pocket to leave the implant in place, the body generates a capsule of fibroblasts that surrounds it, and normally that capsule remains soft and flexible.

This capsule could sometimes begin to harden, this stiffness generating deformity and sometimes pain to a greater or lesser degree. Reason for which it would be necessary to give medical treatment, alternative therapies, and even the need to extract the implant with its capsule and make a replacement, until thinking about a change in the position of the implant or not to place it again.

It has been attributed to glove powder, static and external factors, bacteria, the type of implant, the smooth ones with the highest probability of developing it, reasons not very clear yet (ALSO!).

But this is totally alien to the symptomatology that distinguishes B.I.I.

"I Have Heard About An Implant-Related Lymphoma..."

Indeed it exists, it has nothing to do with B.I.I., it is another medical entity called Anaplastic Giant Cell Lymphoma Related to Implants (BIA-ALCL), it is NOT breast cancer, it is a type of Non-Hodgkin's Lymphoma (cancer of the immune system ) that is generally located in the fluid or scar tissue (capsule) that surrounds the implant, although sometimes it could spread throughout the body. It is manifested by constant, chronic inflammation, pain, the presence of a mass or an increase in volume in the area of ​​the breast implant, mostly YEARS after the procedure has been performed (8 years on average), and accompanied by a liquid around the implant (Seroma).

Although the incidence and risk are low (no more than 600 cases reported worldwide), it must be treated in time as it could lead to death. Treatment that is curative with just removing the implant with its respective capsule, few patients ever need chemo/radiotherapy.

"...I Have No Symptoms, But I Have Implants"

Nothing to worry about, but it is important that you are aware of the existence of this disease, and that in some way, in the event of any changes or symptoms, you turn to your trusted Plastic Surgeon so that they can examine you and guide you.

The life of an implant varies between people and cannot be predicted. NOTHING IS FOR LIFE. This means that all people with breast implants will need additional surgeries, but no one can predict when. Patients can also request additional surgeries to modify the cosmetic result, such as size or shape.

"Doc, I Swear It Is Not Psychological..."

It is clear to me, and many women feel extremely insecure about expressing their symptoms because they fear being judged or classified under some psychiatric disorder, it is not worth mentioning that before reaching the presumptive diagnosis of B.I.I. we must have ruled out any other disorder or physiological alteration, As we mentioned at the beginning, it is important to know that a thousand and one medical and psychological entities can present themselves in the same way.

In my experience, I can share with you that exactly THE SAME symptoms my wife had postpartum and during breastfeeding and she does not have any type of implant in her body. All the product of a significant hormonal imbalance, plus the great changes that being a mother entails.

With this I want to conclude, NOT EVERYTHING has to be implant-related Disease, of course, for those who have suffered it and now have the opportunity to share their experience about the en bloc removal by B.I.I., they refer to it as “The best decision I have made in my life ”,“ Now I feel much more energetic ”,“ I didn't even know that my life could be so different ”,“ I recovered all my energy, I no longer need coffee ”,“ My skin has radically improved .. ”, but this does not mean that this is a magic recipe, nor the panacea for all your ills.

Talking with someone who has gone through it can be one of the best ways to confirm your decision, if we can help you with something to clarify your doubts and disappear or reduce that constellation of symptoms, contact us! We have a network of patients who, like you, have gone through dark times, open to sharing their experiences, and, above all, who today enjoy an alternate reality.

We do not yet fully understand Implant Related Disease, but we continue to work on it to achieve it.

"Seek your INNER BEAUTY, I will reveal your outer one."