The biggest fear for many of my patients about breast implants used for breast augmentation is what they have heard about breast implant in the news and online- Breast Implant Illness.
Breast implant illness- What is it?
Breast implant illness is a constellation of symptoms, many of them vague, which may be due to breast implants. The list is LONG: fatigue, muscle weakness, brain fog, hair loss, autoimmune issues, swollen lymph nodes, hormone issues, rashes, new allergies, headaches, thyroid issues. I have written many blogs on the subject of BII. For patients who have these issues, it is super frustrating. Many of these women have had intensive medical workups, lab tests, and other interventions. They frequently show up to me as a last resort to take out the implants.
The three major theories of BII cause
Why does it happen? I am a big believer in the biofilm thought process- that this is a low grade contamination or infection, centered on the breast implant- a foreign object, which creates a chronic low grade inflammatory state. It makes sense then that removing the foreign object- the breast implant- will make you feel better.
What are the 3 theories?
- BIOFILM HYPOTHESIS: Theory is that bacterial contamination of the implant causes a chronic low grade infection which causes the BII symptoms. Evidence – BII capsules have a significantly higher rate of P.acnes positive cultures vs. control implant capsules.
- AUTOIMMUNE/ADJUVANT HYPOTHESIS: Silicone implants cause an autoimmune reaction, which leads to systemic symptoms. Evidence: Anti nuclear, anti cardiolipin, anti rheumatoid factor, anti- RNA polymerase and anti-dsDNA antibodies have been seen in women with BII
- PSYCHOSOMATIC HYPOTHESIS. There is an underlying psychosomatic issue, which causes the symptoms of BII. Evidence: high correlation of BII in women with irritable bowel syndrome and fibromyalgia.
What the internet says about BII
So when you think you may have BII, you likely read online. The internet has a lot to say about breast implant illness, and most of it is negative, fearful, sad, angry, and disgusted. “No! I bet you DON”T. If you are serious, please look into BII aka Breast implant illness. It is a devastating condition and can be fatal.” “Breast implant illness terrifies me.” There has been growing social media platforms discussion of breast implants, with rising levels of medical mistrust and misinformation.
Journal article analyzing BII discourse
This was an article published in July 2025 in the Aesthetic Surgery Journal. It wanted to go beyond the posts to see what was being said, recognizing what an impact the information spreading on social media has. They wanted to analyze patient perceptions and emotions to BII on social media. “Beyond the Posts: Analyzing Breast Implant Illness Discourse with Natural Language Processing and Deep Learning.”
Study:
- They looked at posts about BII from 2014-2023. They broke into two timelines: 2014-2018 and 2019-2023. They found 6099 posts
- AI language processing models were used to look at feelings (positive and negative) and emotions (fear, sadness, anger, disgust, neutral, surprise, and joy)
- Posts were classified by their highest scoring emotion
Findings?
- 75% of posts were negative.
- Posts peaked in March 2019
- Strongest emotions were neutral and fear
- Positive correlations were seen with explantation rates.
- Breast augmentation surgery peaked in 2021, with 364,753 implants done.
- Explantation rates peaked in 2021, at 71,284.
They concluded “Social media discourse significantly influences patient decisions regarding implant removal.”
What do I think
BII is real. It is super tough, as the symptoms tend to be vague, and frequently it happens around other life changes in women like menopause. Add to that, many of the issues like allergies and autoimmune issues are rising for our population in general, not just women with implants. Our world may be making us sick.
I take great precautions to avoid biofilm. Please read my blogs on the subject, but know that when putting in a breast implant, there are choices you can make to reduce the risk of biofilm. BIOFILM BLOGS. This is not new information to me. For years I have thought biofilm -which leads to capsular contracture- may likely cause breast implant illness. Then a study published which supported it.
But not all women with implants get breast implant illness. And implants may not cause these BII symptoms in women with implants. When the implants are removed the symptoms may not go away. What was the timing of symptom onset? Did it correlate with the breast augmentation? Do you have capsular contracture or any other issues? Where is your incision? Is your breast implant under the muscle? Have you had breast infections? Could this be perimenopause? Was a Keller funnel used? Antibiotics around surgery?
There was a lot of fearmongering which exploded on the internet, much of the information distorted or untrue. There were doctors taking advantage of this to drive business. Our national society came out with a statement directly because of this.
Regardless, if you think your implants are making you sick or you want your implants removed, do it. I do a lot of explant surgeries. Many explant surgeries I do though is because people are larger than they want to be, droopy, or just want the implants out- they are not all symptomatic. Please read about explant surgery HERE.
So my bottom line? Get an evaluation from a board certified plastic surgeon who does a lot of breast surgery– implants and explants. Bring in any information you have on your implants (cards, operation reports) and any work up you may have had (labwork, testing). If you want the implants out, you absolutely can. But I urge you to take a balanced look and use good quality science and sources for information. I am super blunt when talking, and I can walk you through what I think after meeting with you and after doing hundreds and hundreds of breast surgeries over 25 years.
Medical Citation
The information provided on this website is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider for any questions regarding your health or medical condition.
