Dr. Saber’s Blog

What is Breast Implant Illness? Am I At Risk?

Most of us are aware that breast implants are not 100% foolproof. Chances are you’ve seen a sensationalized picture showing a breast implant rupture, or one that got displaced to an odd position. And before I ever do a breast augmentation, I make sure to discuss the possibility of capsular contracture or other complications with all my potential patients.

Most of these complications are relatively easy to explain, and even to see from the outside. But that’s not the case for Breast Implant Illness (BII). This much rarer condition has a loose definition and pretty elusive symptoms. As a result, it’s notoriously hard to diagnose – even though it can cause a lot of pain for women who develop it.

What is breast implant illness (BII)?

Breast implant illness is not a typical disease, where we have a well-defined cause that directly causes a group of symptoms. Instead, it refers to a group of symptoms that sometimes appear together after getting breast implants, whether silicone or saline-filled ones. In many cases, these symptoms also disappear after having an explant surgery (breast implant removal).

The problem is – we don’t know much about the mechanisms that cause BII. We don’t have a specific test for it and it’s pretty rare: breast implant statistics show that less than 1.5% of women with breast implants develop these symptoms. And yet, that’s already often enough for us to have named the condition.

Breast implant illness symptoms

The symptoms of breast implant illness are what we call “systemic symptoms.” This means they are not confined to a specific part of the body. For example, a capsular contracture would cause very specific, confined pain around the breasts. Instead, BII symptoms often affect tissues around the body.

Breast Implant Illness

The most common BII symptoms are:

  • chronic fatigue
  • brain fog
  • frequent headaches
  • recurrent joint pain
  • muscle pain
  • anxiety or depressed moods
  • hair loss
  • frequent skin rashes all around the body
  • itchy or dry eyes

These symptoms can make it very hard to lead a normal life, but they also often appear disconnected from one another. They can easily be mistaken for thyroid disease, chronic depression, or chronic connective tissue disease.

In severe (but extremely rare) cases, some women may develop more serious conditions following breast implant surgery. For example, skin rashes can grow into scaly or thick patches of skin (scleroderma). Dry or itchy eyes, alongside a chronically dry mouth, may grow invasive enough to turn into Sjogren’s syndrome. Chronic joint pain or inflammation may feel very similar to rheumatoid arthritis.

What causes breast implant illness?

We’re not 100% sure. One of the most common theories is that BII is an autoimmune condition — specifically, an autoimmune/inflammatory syndrome induced by adjuvants (ASIA). This means it’s caused by the body’s immune system attacking itself.

Proponents of this theory point out that, in some cases, the silicon in the implants gets mistaken for an invading organism – such as a virus or bacteria. This triggers a body-wide inflammatory reaction, progressively attacking muscles, joints, or other body parts.

The strongest evidence for this? Many autoimmune diseases, such as Lupus, Lyme disease, or fibromyalgia share the same symptoms as BII. However, where lupus causes a visible spike in some inflammatory markers, which we can measure on a blood test, BII often doesn’t. Many patients often experience a wide range of symptoms, but all their tests come back as normal.

There may also be a psychological component to BII. As a result, there are currently many pages out there claiming that “breast implant illness is a lie.” This is a bit of a radical statement that ignores the very real experience of a growing number of women who endure real, chronic pain.

Is this really breast implant illness?

Currently, there is no single blood test, body scan, or exam that can tell us conclusively that a patient’s symptoms stem from their breast implants. However, we can usually tell with relative ease if you don’t have BII.

Some conditions that are often confused with BII include:

Capsular contracture

This is when hardened scar tissue forms around the implant and starts to squeeze it. According to the U.S. Food and Drug Administration (FDA), this is one of the most common “serious complications” that can stem from silicone implants.

Although very painful, capsular contractures cause very defined and unmistakable symptoms. The pain will be confined around the implants, and you may even be able to “feel” the hardness around them. This makes for a pretty straightforward diagnosis.

Breast Implant Illness

Silicon allergies

Silicon is usually regarded as a hypoallergenic material, which is why we use it in a large number of medical devices. As a result, we now use silicone in anything from menstrual cups to cooking utensils.

With that said, silicone allergies do exist, and their effects are usually strong and immediate – especially when we place the silicone inside of you. But as silicone is now used so widely, it would be extremely rare for someone to reach adulthood without knowing about it. Plus, a quick allergy scratch test can usually clarify the issue quickly.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL )

This is an extremely rare form of cancer that’s been linked to an older model of rough-textured implants known as Allergan Biocell implants.  

BIA-ALCL can cause swelling in or around the breast, as well as fever, rashes, weight loss, and the appearance of a lump on the side of the breast or near the armpit. These symptoms partially match those of BII, which is scary – but unless you had Allergan implants, you’re most likely in the clear.

Nowadays, we no longer use textured breast implants, although they were once considered “easier” for women who’ve had reconstructive surgery after a full mastectomy, or as part of gender affirmation surgeries. This is because textured implants were more likely to stay in place, even if they were not surrounded by breast tissue.

 Textured implants were eventually recalled by the FDA, and plastic surgeons no longer use them. As a result, cases of BIA-ALCL will continue to get rarer.

How do we treat breast implant illness?

As we have no definite test for BII, many plastic surgeons are hesitant to make an “official diagnosis.” Instead, women usually come to see us several years after their original breast surgery, and usually after seeing several specialists for all their unexplained symptoms.

This is what healthcare providers call “a diagnosis of elimination;” basically, we’ve ruled out most other culprits, and we move down the list of likely causes. Whether spurred by social media or referred by their rheumatologist, we only have one way to treat BII: removal of the implant and potentially the surrounding capsule.

Once again, here experts disagree a bit: some surgeons believe that once the silicone and capsule are out, the symptoms will disappear. Others believe that it should be done as an “en bloc capsulectomy” – or removing everything in one piece. This prevents any silicone from possibly “spilling” or being left behind, where it would continue to cause issues.  

However, this is a pretty complex procedure, requires a large cut, and often causes more bleeding or pneumothorax (air leaking into the chest). It’s not pretty, it will require a hospital stay, and overall, I prefer not to do it unless there’s no choice.

Following implant removal, replacing the implants is rarely an option because it would defeat the entire purpose of the surgery. In some cases, you can try a breast reconstruction using fat from somewhere else in the body. In my experience, women plagues with breast implant illness rarely see this as an immediate priority – but after healing, and especially if your original symptoms disappear, it may be worth considering.

Dr. Saber – A leading provider for breast implant removal in Los Angeles

Dr. Sepideh Saber, MD, FACS is one of LA’s leading plastic surgeons. Stanford-trained and board-certified, she combines an empathetic approach to her patients with a deep knowledge of surgical technique and input from the latest research in the field.

Her training in reconstructive surgery has allowed her to help hundreds of women who are recovering from breast cancer, are going through a larger transformation, or are dealing with the many effects of silicone implant illness.

To get in touch, call (877) 205-4100 or schedule a consultation online.

The practice of Dr. Saber is located in Encino, CA for patients throughout the Los Angeles area. We are also convenient to Encino, Woodland Hills, Sherman Oaks, Calabasas, Burbank, Glendale, Hidden Hills, Agoura Hills, Northridge, North Hollywood, Malibu, Topanga, Canoga Park, Reseda, Valley Glen, Chatsworth, West Hills, Winnetka, Universal City, Bel Air, Beverly Hills, Downtown Los Angeles, Silverlake, and Echo Park.

Dr. Saber graduated from Stanford University’s world-renowned medical school and did her plastic and reconstructive surgery residency at the equally lauded University of Southern California. She then completed a fellowship at New York University in the extremely challenging and delicate disciplines of hand surgery and microsurgery.

Dr. Saber offers a more sensitive, female perspective for patients of all ages, genders, and orientations. Former patients from all walks of life have praised not only their treatment outcomes but her caring, thoughtful approach to a wide array of appearance and health-related matters.
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    I was fortunate to find Dr. Saber after researching board-certified surgeons who specialize in breast cancer reconstruction revision surgery. I knew I was in good hands from the moment I spoke with the lovely and efficient Marlene, Dr Saber's office manager. Dr Saber patiently listened to my concerns and, after examining me, explained what I could realistically expect the outcome to be from another surgery. She also explained to me that she would need to review my previous surgery notes before we could discuss a possible further surgery, which I found comforting and highly ethical. I also discussed a couple of other procedures that I would like done, including fat removal from my large upper arms that had caused me great embarrassment for several years. Dr. Saber is an excellent surgeon who is incredibly kind and genuine. She truly understands the female body and the emotional aspect of body insecurities yet, she is transparent about what can and cannot be done and takes time to discuss realistic expectations and outcomes. My breast reconstruction revision surgery will take place in the New Year, but in the meantime, I have the most fabulous upper arms that I recently flaunted in a strapless dress (something I have not done in years). Dr Saber is truly one of a kind, and I still cannot believe how fortunate I am to have found her. I highly recommend Dr Saber.

    Linda DeCarlo November 29, 2023

    I don’t have enough wonderful words to describe Dr Saber and Marlene! I had a tummy tuck done this year and from start to finish the entire experience was amazing. Marlene is always so helpful and works so hard to make every detail a breeze for you. When I had my consultation with Dr Saber I was at a point of complete agony with my body. She instantly took that stress and frustration off my shoulders! As a woman not being heard by doctors for years I left that consultation with happy tears knowing I had finally found my Dr. It was a major surgery and I felt completely zen and at peace going in because she really does make you feel that safe. I didn’t think I would ever look the way I do now! She gave me the gift of having the body I kept fighting for. I will never stop recommending her.

    Monica Prusa October 9, 2023

    I saw Dr. Saber when I broke my wrist. I ended up having to have surgery. She did an excellent job and I am healing nicely. She was very professional, but was also very kind and compassionate. I would highly recommend her!!

    Sandy Schaupp September 13, 2022

    I LOVED DR SABER!!! There are a few reasons why I chose her. One was because she’s a female Doctor that was my goal who also did a good job (which I was able to confirm with all her before and after photos) and what sold me was my safety in mind. She made me feel like I was in the best hands ever along with Marlene who coordinated everything THANK YOU LADIES! Dr Saber helped me get back the body I have always desired. I had a lot of stomach fat from weight gain and I lost weight so a lot of my weight was in my front lower and upper abdomen. Now I have a super beautiful curvy body like an hourglass after a tummy tuck and lipo she did. She understood the assignment hahaha . I’m 32 years old no kids just wanted to enjoy my younger body looking and feeling beautiful and she really took good care of me. Even after hours I had an emergency due to my fault but she was there and got back to me very quickly and I’m very grateful. I also think her work says a lot because I stopped taking pain medication on the 3rd day after surgery and was fine with very minimal pain I was able to tolerate the healing process. Highly recommend going with her I just had a wonderful experience and would do it all over again if I had too. Maybe after I have kids. Thanks Dr Saber and team <3

    STEPHANIE d July 15, 2022

    Dr.Saber is by far one of the best plastic surgeons. I love how she takes her time to explain any procedure to the patients understanding. She always makes sure to answers any and all questions.From fillers to body contours she’s the one you want.

    Katherine Melara February 15, 2022

    Dr Saber is amazing! She is caring and very informative. I went in for fillers and she explained procedure step by step. I highly recommend her and look forward to future visits.

    Amanda Vazquez December 18, 2020

    Dr. Saber was friendly, knowledgeable and professional. She took time to listen, answer all my questions and was forthright in her recommendations. Her staff was friendly and helpful. I was very happy with the results and plan on going back. If you are looking for a first rate professional experience look no further she is the doctor for you!

    T R December 18, 2020

    Dr. Saber is one of a kind plastic surgeon with a heart of gold. She is a well verse plastic surgeon that puts her patient's needs before anything else. She genuinely cares about every single patient, and her work speaks for itself. I notice every post-operative result on her Instagram (@saberplasticsurgery) the patients have this glow that radiates through. I have been going to Dr. Saber for my Botox for the past 3 years, and love the results every time. I know who I will be going to for any future plastic surgery needs, and will confidently refer family and friends to Dr. Saber for any Botox, fillers, and plastic surgery consultations.

    Rudy Garcia December 16, 2020

    I have nothing but great things to say about Dr. Saber! I am so pleased with my results from a breast augmentation she performed on me back in late June! She answered all my questions and concerns before and after my surgery. She’s very easy to get in contact with and she’s so nice. She made feel so comfortable throughout the whole process. 100/10 Lover her work!!

    Amanda Villegas October 15, 2020

    Dr Saber is hands down the best surgeon! She took her time answering my questions and explained procedure in detail. After doing liposuction six months ago, I am extremely happy with my results and I appreciate her so much.

    Marlene Cosentino October 15, 2020

    Dr. Saber is so kind and thorough with her patients! She is an amazing doctor and genuinely cars about everyone she comes in contact with. I would recommend her to anyone for any hand surgery or cosmetic procedure.

    Rachel Meach October 15, 2020