Implant Illness Q&A with Dr. Dunkley
- Posted on: Jul 5 2018
Increasing concerns about breast implants causing individuals health problems has prompted me to post this page on implant illness to benefit of our Utah patients. The goal at Envision Cosmetic Surgery is to help patients considering implants make informed decisions and to help those who feel they are suffering from implant illness make smart choices also. This page has my experience and what I have deduced from these experiences.
What is implant illness?
Implant illness is the name given to the negative symptoms women experience after getting breast implants. The symptoms experienced are often allergy-like and may include fatigue, muscle weakness, aches & pains, rashes and slower cognitive functions (brain fog). These symptoms may occur any time after getting breasts implants and for most of the patients I have treated, they begin years after getting implants.
How do I know I have implant illness?
Knowing you have implant illness is difficult. Typically, a patient has not felt well for a significant period of time. Repeated doctor’s appointments and a broad spectrum of tests have ruled out most other medical possibilities. Many women are very happy with the look of their breasts and are reluctant to remove the implants because of the potential cosmetic changes.
Is implant illness real?
I did not believe in implant illness until 2013. In 2013 a patient came to me because she wanted her implants removed for implant illness. She had a rash over her abdomen and chest which had been present for about three months. Two years previously the rash had appeared and stayed for six months. All tests her various doctors had run were normal. There was no explanation for the rash. Convinced her implants we’re giving her the rash, she decided to have them removed. Despite my doubts, she scheduled her surgery. Because of the information she had read on the Internet, she wanted her capsule, the scar tissue that forms around the implant, removed as well.
I removed her implants. Her capsule was noted to be extremely thin, therefore, the capsule was not removed since to do so would require removing a significant amount of breast tissue, likely giving a much poorer cosmetic result. The implants removed were saline implants. The usual concern with implant toxicity is that the implant will break and silicone will be floating freely through the body. Saline implants have a solid silicone shell that is filled with simple IV fluid. If it breaks, the body simply absorbs the fluid.
The following week when I saw the patient, much to my amazement, her rash was nearly gone. I was stunned. Since this time, I have removed implants from a number of women almost all of whom have said their health has improved. Keep in mind, most of these women had done extensive testing and ruled out any other cause of their symptoms. This experience brought up a number of concerns for me personally, first and foremost, should I be offering breast implants or is silicone safe.
Is silicone toxic to the body?
I have done more research on silicone since realizing implant illness is real. Liquid silicone injected in large quantities is definitely detrimental to a person’s health. However, small quantities of liquid silicone are used routinely without adverse effect. Also implants in a majority of patients, seem to have no effect on their health. How can this be? And why would a saline-filled implant with a silicone shell affect someone’s health since no liquid silicone is flowing freely through the body?
I have come to the following conclusion. The symptoms are often described as allergy like for a reason. Some women are indeed allergic to silicone. Much like a person with a nickel allergy will react if a nickel button is touching their skin, a patient with an allergy to silicone will react to an intact silicone shell when in contact with it. However, like a nickel allergy or hay fever, not everyone has these allergies and the majority are fine to get implants.
How can I know if I have a silicone allergy?
Silicone tape strips are used for wound healing. A patient who is concerned about being allergic can wear a silicone tape strip on their body for 1-4 weeks before their surgery. Again, the majority of patients are fine. There is a rising number of women discussing their problems with implant illness, but keep in mind that a much larger number of women have implants and never have a problem. However, at present implant illness is getting more attention and with the internet making communication much easier, more women are sharing their experiences for all to hear.
What is en bloc resection?
En bloc resection means to remove as a whole. In other words, to remove the implant and scar tissue in one large lump. This is virtually impossible unless an incision is made from about 4:00 to 9:00 on the breasts, approximately the diameter of the implant or 5-6 inches long. The implant can squeeze through a small opening, but when it has a shell of scar tissue around it, it loses its elasticity and will not squeeze through a small hole.
The scar tissue that forms around the implant is called a capsule. When patients request en bloc removal, typically the original incision is opened. The cautery is used to reach the capsule and open the capsule. The implant itself is removed, and then the capsule is removed in pieces. This accomplishes the same thing as en bloc removal without significantly increasing the incision size. Completely removing the capsule is very time consuming and therefore costly.
Patients ask if leaving the capsule leaves “toxins” in the body. If the “allergy” example is followed, a person who reacts to nickel doesn’t have their skin removed. Any trace amounts of metal initially present when the offending object is removed, is later removed by the body. The skin takes some time to return to its normal state. The same should be true of silicone contact from implants. Your body will clear any remaining residue. When the patient in my above example (“Is implant illness real”) had her implant removed, despite leaving the capsule, she immediately improved.
Another consideration is how am I going to look after having my implants removed. The example patient’s capsule was very thin. A healthy thin capsule can be compared to the thin membrane that connects the cracked pieces of an egg shell when peeling a hard-boiled egg. To remove a capsule lining this thin is difficult and requires removing healthy breast tissue with the capsule. Any tissue removal can affect the breasts volume, shape and look after removing the implant. Conversely, a thick capsule is easier to dissect as it creates an obvious plane to follow though it still removes tissue affecting volume, shape and look after removing the implant.
How will my breasts look after removing breast implants?
After removing implants breasts are smaller and usually droopier. Implants give upper breast fullness found no other way. Many women need a breast lift or some other volumizing solution to be happy with the look of their breasts after implants are removed. A lift gets the natural tissue back up on the chest where it belongs but leaves more scars. The single best option for breast enhancement without implants is fat grafting.
Fat grafting is taking fat from another area of the body by liposuction and then re-injecting that fat into the breasts. Patients benefit from the increased volume in the breasts and enhance contour where the fat is taken from. The only downside is that not all the fat survives as it has to re-establish a blood supply. Also, the more natural tissue you have the more space there is to put fat in. Fat placed into the vacant implant pocket would nearly all die as it is not held closely enough to the healthy tissue to obtain blood flow.
What should I do if I think I have implant illness?
Patients should see their primary care physician if they have medical concerns. The first step is to determine if other conditions are adversely affecting your health. If you have followed this course and are still having problems, set up a consult with Dr. Dunkley at Envision Cosmetic Surgery. You and I can decide on a plan for you that may be as simple as removing the implants only, or more involved to include a lift and fat grafting.
As always, my goal for our Salt Lake City patients is to “transform lives by increasing self-confidence in your physical appearance for the purpose of improving mental and physical health.”
Posted in: Breast Augmentation