This is in my October 2022 Plastic and Reconstructive Surgery Journal Best Paper Awards. This was a salient topic: “Outcomes of Implant Removal and Capsulectomy for Breast Implant Illness in 248 Patients.”
Does removing the implant and capsule remove the Breast Implant Illness (BII) symptoms? What do they find?
BII is a constellation of symptoms- rashes, brain fog, joint issues, pain see my blogs HERE– and the concern is that they are related to the breast implants. There are studies which indicate that biofilm leads to BII, and I have been speaking to this for years. Biofilm creates low grade chronic inflammation, and I absolutely believe that can lead to BII symptoms.
So this study was to try to give science to the removal and capsulectomy.
Study:
- Retrospective look at demographics, presenting symptoms, outcomes, capsule histology, cultures from the implant pocket before capsule excision, and results.
- 248 patients
- 93% were cosmetic placement
- Median age of placement was 29.5
- BMI average 24
- Most common presenting BII symptom: nonspecific generalized pain and fatigue
- Capsular contracture was seen prior to the surgery: 55% were Baker II, 39% were Baker III/IV
Findings:
- 23% of capsules has inflammation changes on pathology
- This inflammation was independently associated with silicone (vs saline) and textured implants (vs smooth)
- 4.8% had silicone in the capsules
- About 3% had positive cultures, mostly Staph
- 15% were found to have a ruptured implant
- 98% of patients had total capsulectomy, though only 11% of these were removed intact
Conclusion:
“A subset of patients with BII there is an underlying inflammatory response associated with the implant capsule, more common in silicone and textured implants. This response may be associated with symptoms of BII. More research is necessary.”
My thoughts?
Speaking to the choir here. Biofilm and chronic inflammation can make you feel bad. It is why I take so many precautions when I do place breast implants, and why I feel you must remove the implant and the capsule with breast explant surgery to fully treat biofilm. Breast implant illness and biofilm and chronic inflammation are all tied together for me.