Breast Implant Illness

BY DR. SHELBY ENTNER, nd

Millions of women have made the decision to get breast implants. For some it may be due to having a few children and finding that things aren’t sitting where they used to afterward! Sometimes it is because of a concern about asymmetry or a desire to have larger breasts, which is still considered more culturally ideal in our society. And for many women it can be a serious illness such as breast cancer and subsequent mastectomy that leads to the decision to get implants. So, are there risks or concerns about getting breast implants? Besides the initial surgical risks, there are few discussions about possible long-term risks. In the last few years, Breast Implant Illness (BII), a chronic and diverse type of sickness that comes from breast implants, has become better understood and better researched.

DR. SHELBY ENTNER, nd is a licensed Naturopathic Physician and the owner and founder of Vero Health Naturopathic Medicine in the Okanagan. She earned her doctoral degree in Naturopathic Medicine in 2002 after ten years of studies. Dr. Shelby empowers patients to make changes that are in alignment with their health values and goals and seeks to find answers by looking at the whole picture, instead of simply at a symptom.

The most common symptoms of BII can be generalized into (1) musculoskeletal, (2) cognitive, and (3) systemic. Musculoskeletal symptoms include muscle pain and joint pain. Cognitive symptoms are brain fog, memory loss, fatigue, and difficulty concentrating. Systemic/rheumatological symptoms include visual disturbance/dry eyes, rash, and autoimmune diagnoses. Patients are tired, anxious, get weird rashes, feel like they’ve been hit by a truck, and can’t get any answers from running tests and seeing numerous doctors! It is still a poorly understood condition and one that I hope to educate you about today.

In a 2020 article in the journal Plastic and Reconstructive Surgery, the authors were quoted as saying “Although BII has yet to reach mainstream acceptance in medical/scientific fields, concern regarding the appearance of systemic illness following the insertion of breast implants has been present for decades. The nebulous and varied nature of symptoms, along with the difficulty of identifying causative agents, has rendered the phenomenon difficult to examine, although the efficacy of explanation as a treatment has been well demonstrated.” In English, the authors are saying that BII is hard to pinpoint medically with such a variety of symptoms, but the treatment of implant removal, or “explanation”, resolves many women’s health concerns. So what could be the reason these implants are making women sick?

Silicone implants have been used for reconstructive breast surgery since the 1960s; however, they have a controversial history clouded by lawsuits and a growing body of research from the past two decades linking them with autoimmune-related complications, collectively known as autoimmune/inflammatory syndrome induced by adjuvant (ASIA). The symptoms listed in a 2015 journal were fever, fatigue, skin lesions, and an arthritis that resembled rheumatoid arthritis. It is believed that the underlying autoimmune reaction is from a combination of environmental factors (biofilms, volatile organic chemicals) with genetic predisposition. While studies going back to the early 1990s have shown a connection between silicone gel implants and autoimmune disease, the implants continue to be used today!

Volatile organic chemicals (VOCs) such as benzene, cyclohexanone, toluene, phenol, and ethyl acetate are found in silicone implants. This category of chemicals has been shown to be neurotoxic (damages the nervous system) as the lipophilic (fat-loving) VOCs can accumulate in the brain, and they can also be stored in fat cells and then slowly released into the bloodstream over time. Neurological symptoms that may be experienced include numbness, loss of sensation, brain fog, mood swings, headaches, memory loss, weakness, and fatigue.

Saline implants are often considered “safer” but they have a silicone rubber outer shell. “Silicone gel bleed” is a term used to describe the diffusion or leaching out of chemicals from the silicone gel through the shell into the rest of the body; it can occur with both saline and silicone implants. Unfortunately, neither type of implant can be considered safer than the other.

Chemical toxicities can impact brain function and contribute to immune dysfunction by weakening the immune system or over-activating it like in autoimmune disease. These VOCs can cause distress on the endocrine system (thyroid, adrenals, female hormones), affect intestinal health, and bombard the liver and kidneys, as the body is trying to rid itself of these chemicals.

Another area of concern is the creation of biofilms that adhere to a surface of an implant. Biofilms are a protective “shield” that allow bacteria and fungus to grow unchecked by the immune system. We often find them in other implants such as in dental surgery and joint replacement, and they can cause the immune system a great deal of stress. The most prominent biofilm with breast implants is Propionibacterium acnes. One study showed that the women who presented with BII symptoms were cultured 36% more often with this bacteria compared to controls. P. acnes has been connected to various rheumatological disorders, including CREST disease, thyroid disease, sarcoidosis, and endophthalmitis (inflammation of the eye). Studies going back to the early 1990s have shown a connection between silicone gel implants and autoimmune disease, the implants continue to be used today!

Breast Implant Illness has varied symptoms including musculoskeletal (e.g. muscle and join pain), cognitive (e.g. brain fog, and systemic (e.g. autoimmune diagnoses). It is a poorly understood condition.

In the last year alone, I have had many women decide to have “explant” surgery due to a myriad of symptoms they have experienced since their initial surgery. For some women it was due to not feeling well since their initial surgery, for others it was due to having strange and unrelated symptoms that they couldn’t resolve with lifestyle changes or lab testing. And some women read other women’s stories of having BII and it struck a chord for them and their bodies. Breast implants have been celebrated as a way for women to change their bodies to make them feel more feminine or sexy, or to regain something they had lost over time or for medical reasons. For women who have felt like something flipped in their health after their implants, explantation has been an answer. Due to the VOCs, biofilms, and other concerns about a foreign body being in the body, having the source of the trigger removed has been a game changer.

Find a trusted plastic surgeon who understands the proper methods for removal, and a doctor to help you prepare for the surgery with natural medicine. Realize that any surgery can have an emotional and physical healing period afterward, and a decision to take out implants is a big one! As we understand more about Breast Implant Illness we can hopefully prevent more women from getting sick and can change the industry to make sure what we put inside us doesn’t make us ill. Potential implant candidates should always have full informed consent about the potentially serious complications from breast implant surgery. And as doctors, we now know another avenue of information when helping patients with autoimmune conditions or chronic illnesses.

FOR THOSE DAYS WHEN YOU’RE TRYING TO DECIDE IF A SPOONFUL OF PEANUT BUTTER COUNTS AS “MAKING DINNER.”