{"id":2303,"date":"2019-08-08T16:00:55","date_gmt":"2019-08-08T16:00:55","guid":{"rendered":"https:\/\/www.brzowski.com\/blog\/?p=2303"},"modified":"2019-08-08T16:00:55","modified_gmt":"2019-08-08T16:00:55","slug":"qa-with-dr-brzowski-about-breast-implant-illness-bii","status":"publish","type":"post","link":"https:\/\/www.brzowski.com\/blog\/qa-with-dr-brzowski-about-breast-implant-illness-bii\/","title":{"rendered":"Q&A With Dr. Brzowski about Breast Implant Illness (BII)"},"content":{"rendered":"\n

Q:<\/strong> What is Breast\nImplant Illness (BII)? <\/p>\n\n\n\n

A:<\/strong> There are\nwomen with breast implants who self-identify (they have individually and\nwithout the aid of a medical professional determined that they are suffering\nfrom this disorder) and present with various systemic symptoms that they\nbelieve are related to their breast implants. They refer to these symptoms as\nBreast Implant Illness (BII). Breast Implant Illness (BII) is a term used by these\nwomen who to describe a variety of symptoms including (but not limited to)\nfatigue, chest pain, hair loss, headaches, chills, photosensitivity, chronic\npain, rash, body odor, anxiety, brain fog, sleep disturbance, depression,\nneurologic issues and hormonal issues that they feel are directly connected to\ntheir saline or silicone, breast implants. They likewise do not\ndistinguish between smooth or textured devices. \nThe recent increase in patients reporting Breast Implant Illness (BII)\nsymptoms appears to be related to social media. There is one Facebook group\nalone with more than 50,000 members, all of whom report Breast Implant Illness\n(BII) symptoms. This is not to say that social media is the cause of Breast\nImplant Illness (BII) however, it may account for the rapid increases in\npatient reporting. BII IS NOT AN OFFICIAL MEDICAL DIAGNOSIS.  I cannot stress this point firmly\nenough.  No medical organization or body\nof physicians has established this as a true medical disorder.  The terminology and existence of such a\nphenomenon has originated solely from within the group of individuals who feel\nthat their breast implants are to blame for the symptoms that have been\nmentioned above. <\/p>\n\n\n\n

Q<\/strong>: Is there a\nlink between medical grade silicone implants and any disease? <\/p>\n\n\n\n

A:<\/strong> Silicone is an\nelement that exists in nature as crystalline silica, which has been shown to\nactivate the immune system in conditions such as systemic sclerosis which has\nbeen seen in stone masons. Silicone used in breast implants is different and to\ndate has not been proven to cause any disease. This silicone does not exist in\nnature, it is created by hydroxylating silica to form polydimethylsiloxane.\nMedical grade silicone has had antioxidants, dyes, and plasticizers removed\nduring processing. <\/p>\n\n\n\n

Q:<\/strong> Are there any\ntests that would indicate a connection between breast implants and symptoms\nthat are being labelled Breast Implant Illness (BII)? <\/p>\n\n\n\n

A:<\/strong> There is no\ndiagnostic testing specifically for Breast Implant Illness (BII). There are\ntests for autoimmune diseases that can be performed to evaluate for potential\ncauses of a patient\u2019s symptoms. There are patients who have symptoms they\nattribute to Breast Implant Illness (BII) with positive immune testing and\nothers with all laboratory tests which show no abnormalities.   Lab testing for BII is not possible.<\/p>\n\n\n\n

Q:<\/strong> Is there any\nscientific data that shows that breast implants cause these symptoms or any\ndisease entity? <\/p>\n\n\n\n

A:<\/strong> NO.  In 1999, The Institute of Medicine Committee\non the Safety of Silicone conducted an extensive review of the available\nliterature and concluded there was no demonstrated clear link between\nsilicone implants and any systemic illness. There have been studies of many different\nsizes and design to look at the safety of breast implants themselves. These\nhave looked at specific autoimmune disorders and diseases. In aggregate, these\nstudies show little to no links between breast implants and any disease.\nStudies of patients who have symptoms that they have related to their breast\nimplants have not shown consistent laboratory abnormalities to define a\ndistinct syndrome. In fact, because of the large volume of studies performed\nusing the most rigid scientific methods that failed to show any medical\nconcerns with regards to silicone breast implants and these types of disorders,\nthe FDA permitted largely unrestricted use of these devices in November of\n2006.  To-date, there has been very\nlittle in the way of research into this entity that has been labelled Breast\nImplant Illness (BII) by women with breast implants. <\/p>\n\n\n\n

Q:<\/strong> Does implant\nremoval improve patient\u2019s symptoms or cure a patient who has a medically\ndiagnosed disease entity like an autoimmune disease? <\/p>\n\n\n\n

A:<\/strong> Various\nstudies show different degrees of improvement in patient symptoms after removal\nof their breast implants, some of which are temporary, and some showing\npermanent resolution of symptoms.  However, there are no consistent responses to\nimplant removal in this group of patients: \nsome have improvement, some do not. \nThis further confuses the issue regarding any relationship between these\nsymptoms and the existence of breast implants.<\/p>\n\n\n\n

Q:<\/strong>  What are plastic surgeons doing to better\nunderstand this group of systemic symptoms being called Breast Implant Illness\n(BII)?   <\/p>\n\n\n\n

A: <\/strong>Because there\nare many women that self-identify as having Breast Implant Illness (BII), we\nare listening. There is a new scientific study being created to examine this\nentity. We cannot yet define BII and therefore cannot say with any certainty\nthat it exists, because we do not have any tests we can run to prove or\ndisprove its existence. However, we can listen to and partner with our patients\nto determine what is the best course of action to address their complaints, be\nit explantation or otherwise. <\/p>\n\n\n\n

Q:<\/strong> What needs to\nbe done when a patient complains of Breast Implant Illness (BII) symptoms? <\/p>\n\n\n\n

A:<\/strong>  Options can include further medical work up\nwith or without the consultation of a rheumatologist, observation without\nmedical work up, implant removal without capsulectomy, exchange with or without\ncapsulectomy, removal with total capsulectomy, or removal with en bloc\ncapsulectomy. Patients who present with concerns of Breast Implant Illness\n(BII) have real symptoms that often cannot be categorized into any specific know\ndisease entity. This does not mean their symptoms are not real and they deserve\na full evaluation. The various options need to be discussed and hopefully, with\nfurther research, we may be able to determine which patients may see symptom\nimprovement or resolution with removal of their implants and which may not see\nany change. <\/p>\n\n\n\n

Q:<\/strong> If after the\ndiscussion of risks and the possibility of no improvement of symptoms post-explantation\nis discussed with a patient, what should be done if the patient demands an \u201cen\nbloc\u201d or \u201ctotal\u201d capsulectomy with their explantation? <\/p>\n\n\n\n

A:<\/strong> There are many\nmedical inaccuracies perpetuated by the internet. BII patients tend to believe\nthat a total capsulectomy is necessary to remove all causative agents and they\nprefer it en bloc.  It is important to understand\nthat it is not always possible to remove all of the capsule. Sometimes a\nportion of the capsule must be left behind or is disintegrated with the use of\nelectrocautery to prevent significant damage to muscle, rib or lung.  There are increased surgical risks associated\nwith en bloc capsulectomy which requires a complete dissection of all the\ntissues surrounding the breast implant. \nFurthermore, we do not have enough collective data to guarantee any\nimprovement in the symptoms labelled Breast Implant Illness (BII).<\/p>\n\n\n\n

Q:<\/strong> What is the\nrisk of developing Breast Implant Illness (BII)?<\/p>\n\n\n\n

 A:<\/strong> As there is no definitive link\nbetween the often subjective and divergent list of symptoms, and no means for\ntesting, there is no \u2018known\u2019 risk. Many of the symptoms described by breast\nimplant patients are experienced by the general public on a regular basis with\nor without implants. That isn\u2019t to write-off a potential connection, but no\nconnection has been established to-date. <\/p>\n\n\n\n

Q:  What is the FDA\ndoing about complaints regarding the existence of Breast Implant Illness (BII)?<\/p>\n\n\n\n

A:\u00a0 On March 25 and 26, 2019, the General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee will discuss and make recommendations regarding the benefits and risks of breast implants indicated for breast augmentation and reconstruction concerning the following topics: (1) breast implant associated anaplastic large cell lymphoma (BIA-ALCL); (2) systemic symptoms reported in patients receiving breast implants; (3) the use of registries for breast implant surveillance; (4) magnetic resonance imaging screening for silent rupture of silicone gel filled breast implants; (5) the use of surgical mesh in breast procedures such as breast reconstruction and mastopexy; (6) the use of real-world data and patient perspectives in regulatory decision making, and (7) best practices for informed consent discussions between patients and clinicians.\u00a0\u00a0 During this meeting, no new scientific evidence not already available to plastic surgeons will be assessed.\u00a0 No previously unknown information will be revealed from breast implant manufacturers.\u00a0 The FDA will only have the testimony of the experts in breast implants (many of whom have presented research and data to the FDA previously) and the testimony of private individuals concerned with this issue surrounding breast implants (historical and anecdotal accounts).\u00a0 It is highly unlikely that the FDA will come to any conclusion not already reached by the medical community:\u00a0 there is no demonstrated clear link between silicone implants and any systemic illness.\u00a0 Many of us believe that the FDA will suggest continued research into the topic and that we continue to monitor any symptoms that occur within our patients and that these be reported into a large national data bank (which I do participate in).\u00a0 Furthermore, it is most likely that the FDA will not suggest any alteration in our current practices and that they will continue to support unrestricted use of all types of currently available silicone implants for both aesthetic and reconstructive procedures.<\/p>\n\n\n\n

<\/p>\n\n\n\n

BIOCELL Replacement Warranty<\/a>Download<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"

Q: What is Breast Implant Illness (BII)? A: There are women with breast implants who self-identify (they have individually and without the aid of a medical professional determined that they are suffering from this disorder) and present with various systemic symptoms that they believe are related to their breast implants. They refer to these symptoms … Continue reading Q&A With Dr. Brzowski about Breast Implant Illness (BII)<\/span> →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2303","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"\nQ&A With Dr. Brzowski about Breast Implant Illness (BII) - Brzowski Plastic Surgery | Blog<\/title>\n<meta name=\"description\" content=\"Q: What is Breast Implant Illness (BII)? 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