Eight years after getting her breast implants, Mrs J found herself lying in an operating theatre, waiting anxiously for the surgeon to remove them. Breast implant illness is not recognised by many doctors, but she shares her story.
“Implants weren’t something I planned for,” says the mother of four, who decided on going from C cups to double Ds in 2011. “But I breastfed my kids and felt my boobs could look better.” It wasn’t until several years later that she experienced a range of strange symptoms. “I was bloated and tired all the time, and I had this intense itch on my upper arms, but there was no rash.” After taking her complaints to the gynae and getting several tests done, Mrs J was diagnosed with low DHEA and testosterone. Her thyroid, according to the results, wasn’t functioning properly either. This spooked the woman, who was a relatively healthy person who didn’t drink.
“I researched to find out what it could be,” she said. “But there seemed to be few answers until I found a Facebook group.” In it, hundreds of ladies who had breast implants had come forward with stories of similarly terrifying, and occasionally vague, symptoms, from chronic fatigue and chest pains to hair loss and headaches.
Called “Breast Implant Illness and Healing by Nicole”, the group hit 100,000 members by late 2019, making it the largest group dedicated to implant-related illnesses.
BII – A mysterious malady
It wasn’t so long ago that the world watched transfixed as Pamela Anderson ran slow-mo in the opening scenes of Baywatch. Celebs were flaunting their gravity-defying mounds as casually as they were their Birkins, making it a must have accessory among the masses.
Breast augmentation continues to be the most common cosmetic surgical procedure worldwide after liposuction, with over 1,795,551 augmentations performed in 2019. This is despite an alarming report by the US Food and Drug Administration that was published two years before, linking nine deaths to a rare form of cancer called breast implant-associated anaplastic large cell lymphoma, or BIA-ALCL.
Fortunately, breast implant-associated lymphoma is rare. Caused by textured implants, the risk is about 1 in 30,000 and there has been only one reported case in Singapore, according to plastic surgeon at AZATACA Plastic Surgery, Dr Christopher Chui.
But stories like Mrs J’s show that it isn’t just cancer we should be worried about. While the link between breast implants and systemic disease has been reported since the 1960s, the male-dominated medical community has only recently coined a term to describe it: breast implant illness (BII). And unlike BIA-ALCL, BII may develop in patients with all types of implants: smooth or textured, silicone or saline.
Unfortunately, BII – which is thought to be an autoimmune response to the silicone – is not an official medical diagnosis. This is not surprising, given that diseases that disproportionately affect women receive a fraction of the research funding compared to diseases affecting men. The BBC calls it a “pain bias”, but no one knows whether it stems from gender inequality, a lack of medical research on women, or actual differences between how the male and female brain perceives pain.
Nevertheless, Dr Chui says there has been an uptick in requests for implant removal. “I have encountered about five patients who’ve felt that their implants were causing systemic symptoms and wanted them removed,” he says. “Removal of the implant will usually result in resolution of the symptoms.”
Breast implant illness (BII) or something else?
Most plastic surgeons remain doubtful of BII’s existence. According to Dr Wong Chin Ho of W Aesthetics, patients’ symptoms or poor health may or may not be related to BII. “There are no specific tests to diagnose it,” he says. “You could go for a check for inflammatory markers in the blood, but that’s just like taking your temperature when you’re sick. High inflammatory markers may or may not be related to implants.”
Dr Wong says many of these symptoms may instead be associated with a variety of psychosomatic factors like depression or anxiety. “Therefore, it’s unpredictable if these symptoms will improve or resolve with removal of the implants.” “The most important thing for patients is to talk to their plastic surgeons to come to an informed decision on the course of action needed to address their concerns,” he adds.
Meanwhile, a few parties have accused Facebook of hiding the Breast Implant Illness and Healing group at the peak of its popularity. “I’m not surprised that some people still don’t think it’s real,” says Mrs J. “Initially, I, too, thought it was all in my head.” She scheduled her explant surgery in 2019, after joining the group and receiving information and the emotional support she needed from it. The moment she stood in front of the mirror, post-surgery, was one she’ll never forget. “When you first have implants removed, it’s very hard to look because everything is wrinkled and deflated.”
Meanwhile, breast specialist Dr Melanie Seah has some advice for those who do plan to go under the knife, revealing that there are several other non-health related factors to consider. “Patients should know that there will be revisions and implant exchanges and replacements along the way. Apart from rare cases of lymphoma and BII, there can also be complications such as contracture of the capsule surrounding the implant, and this may lead to an undesirable appearance.” The risks, too, tend to increase with time. “The longer the implants are with you, the more likely you are to experience adverse outcomes.”
Things eventually took a better turn for Mrs J – her bloating went away and in no time she was back to her old self, sans meds. And her breasts? “They’re now back to their old self after I gave it some time. And I’m okay with that.
Safer ways to achieve fuller breasts
“A mastopexy – or surgery to rearrange your own breast tissue to give it a perkier boost – could help.” – Dr Seah
“Fat grafting can be done to augment the breasts naturally.” – Dr Chui
“If there is significant sagging of the breast, then a mastopexy done together with fat grafting would be necessary.” – Dr Wong
This article first appeared in the October 2021 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!
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