Breast Implant Removal
When Should You Consider Breast Implant Removal?
Dr. Ferrari demonstrates the importance of removing a ruptured silicone breast implant.
Millions of women have had breast implants placed over the past 50 years. The vast majority have had no negative side effects. There was controversy in the early 1990’s over the safety of silicone implants leading to a partial ban on silicone implants by the FDA.
After extensive studies, the FDA released silicone for general use in 2006 after finding that silicone and saline implants had essentially the same complication rates. Many articles have been published over the past 20 years regarding “silicone-induced diseases”. Likewise, articles have been published showing that silicone and saline implants are not causing diseases. So, the “jury” is still out. However, there is one entity that no one disputes. Anyone can have chronic infection of a foreign body (breast implant, pacemaker, artificial joint, or any other implanted synthetic object).
Germs can live on a foreign body and secrete a “bio-film” which is like an umbrella covering them. Therefore, antibiotics or your own natural immune system cells cannot fight this infection. The germs live on the foreign body and give off their waste products thereby causing a whole host of symptoms such as fatigue, itching, rashes, tingling, joint pain, toxic shock syndrome, insomnia, depression, hair loss, memory loss, headaches, mood swings, etc.… The human body will typically detect there is a problem and wall off this infection with layers of scar tissue.
This makes it even harder for the immune system cells or antibiotics to attack these germs. Therefore, the only way to clear this type of problem is by removing the foreign body and the surrounding scar tissue capsule. Then the body’s immune system is able to clear out the remaining germs because they no longer have the foreign body on which to latch on. However, it is important to emphasize that this may or may not cause the improvement of the symptoms. Also, it may take months or years to fully recuperate from the damage done by the chronic infection.
Breast Implant Illness (BII) is not a recognized medical diagnosis. It was derived from women with breast implants (saline or silicone) who self-diagnosed because they had various total body symptoms which they believed to be related to their breast implants.
The symptom could include (but were not limited to) chronic fatigue, chest pain, hair loss, headaches, chills, photosensitivity, chronic pain in various body parts, recurring infections, dry eyes or visual disturbances, night sweats, numbness or tingling in the extremities, unexplained rash (or rashes), foul body odor, photosensitivity, new-onset anxiety, brain fog, memory loss, sleep disturbances, depression, various neurologic issues, and even unexplained hormonal issues.
As you can see, the constellation of symptoms is very diverse and the actual cause of these symptoms is oftentimes difficult to figure out. Due to increased attention to this entity on social media, there has been a recent increase in patients reporting Breast Implant Illness (BII) symptoms. There is one BII Facebook group in particular that has more than 50,000 members.
Since BII is not a well-defined medical entity, there is no specific lab test available. Physicians have often times worked up patients with some of the lab tests listed below to rule out other causes of the symptoms.
While there is no one definitive test to determine if your implants are the root of your illnesses, the following tests have been often used to investigate some of the problems caused by breast implants:
One of the theories as to why breast augmentation causes illness is because implants are large foreign objects which can overwhelm and impair a woman’s immune system and this causes the immune system to become dysfunctional and possibly trigger auto-immune symptoms.
The theory continues to say that if the immune system becomes dysfunctional, it could allow opportunistic bacteria and fungi to grow out of control. This could cause serious bacterial and fungal infections in a woman’s body. These germs would then produce large amounts of bio-toxins that overload the organs. In addition, there are concerns that the implants themselves are “toxic” (even though the FDA has declared silicone to be biologically inert).
The problem with this theory is that if it were true, then the vast majority of women with breast implants would suffer similar symptoms. This is obviously not the case. In fact, in 1999, The Institute of Medicine Committee on the Safety of Silicone conducted an extensive review of the available literature and concluded there was “no demonstrated a clear link between silicone implants and any systemic illness”.
Since then, there have been many scientific studies of many different sizes and designs to look at the safety of breast implants themselves. These studies have looked at specific autoimmune disorders and other diseases. In aggregate, as of November 2019, these studies, (with the exception of ALCL related to textured breast implants), show little, if any, links between saline or silicone breast implants and any disease. Studies of patients who have symptoms that they have related to their breast implants have not shown consistent laboratory abnormalities to define a distinct syndrome or illness pattern.
Various studies show different degrees of improvement in patient symptoms after removal of their breast implants, some of which are temporary, and some showing permanent resolution of symptoms.
Some studies indicate that the improvement could be a “placebo effect”. There are no current scientific studies that specifically show which symptoms may or may not improve with implant removal with or without capsulectomy (i.e. complete removal of the scar tissue capsule around the implants).
In other words, there is no guarantee that the removal of breast implants (with or without capsulectomy) will improve a patient’s symptoms or cure any other illness.
There are 3 procedures that can be done. The first procedure is an implant removal without capsulectomy. (A capsulectomy involves removing the entire scar tissue capsule around the implant.)
The problem with this operation is that if there is a chronic infection in the scar tissue capsule, the infection will not resolve. The second procedure is implant removal with capsulectomy. In this type of surgery, the implant is removed first and then the scar tissue capsule is removed.
On the day of surgery, multiple cultures would be sent off to a lab for analysis to see if there are any organisms growing in the breast implant pocket. The scar tissue is also sent to a pathologist for microscopic analysis.
The third possible operation would be an En Bloc procedure. This means that the implant and scar tissue capsule is removed simultaneously as one big “block”. This is often done when it is known pre-operatively that a silicone implant has ruptured because it helps contain the “free” silicone inside the scar tissue capsule.
An En Bloc removal is rarely done with saline implants. Also, this surgery takes longer than the removal of implants with capsulectomies (therefore more expensive) and requires a much larger opening to get all the contents out in a single block of tissue.
In any of the procedures listed above, a drain is placed in each breast to remove the dilute bloody (serosanguinous) fluid that is generated from the surgical trauma. The drains typically stay in for 1-2 weeks. The recovery for the first surgery is very quick, but the second and third surgeries require more time to recover. Most women take a week off from a desk job and don’t exercise for 3 weeks.
How soon after my implants and scar tissue capsules are removed will I start to feel better? There is no guarantee that removing the implants and scar tissue capsules will improve your health.
Since the symptoms women experience tend not to be isolated to the breasts (such as breast pain only), removing the implants may have no benefit in curing total body symptoms.
If the symptoms were caused by the implants being chronically infected, then patients sometimes start feeling better within 1-3 weeks after surgery. If an infection has been there for years, it could take longer to have a full recovery. If the cultures demonstrated an infection, patients are often referred to as an infectious disease specialist. Some patients have also chosen to have “detox” protocols at physician’s offices that deal with “natural healing”.
There is no guarantee that removing the implants and scar tissue capsules will improve your health. Since the symptoms women experience tend not to be isolated to the breasts (such as breast pain only), removing the implants may have no benefit in curing total body symptoms.
If the symptoms were caused by the implants being chronically infected, then patients sometimes start feeling better within 1-3 weeks after surgery. If an infection has been there for years, it could take longer to have a full recovery.
If the cultures demonstrated an infection, patients are often referred to as an infectious disease specialist. Some patients have also chosen to have “detox” protocols at physician’s offices that deal with “natural healing”.
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