Breast Implant Illness: Improving Patient Safety – Part 2

In this special three part series of PSC Deep Dive, board certified plastic surgeon Dr. Melinda Haws of Nashville, Tennessee moderates an all-female round table discussion on breast implant illness (BII).

The conversation features Dr. Patricia McGuire, aboard certified plastic surgeon from St. Louis, Missouri, Dr. Jennifer Kessmann, a board certified family physician from Dallas, Texas, Jamee Cook, a breast implant illness patient who runs several online patient support groups, including the Facebook-based group, Breast Implant Victim Advocacy, and Raylene Hollrah, a breast cancer survivor of 12 years, BIA-ALCL patient and administrator of several online patient support groups.

What is Breast Implant Illness?

Anytime breast implant illness is discussed, it’s important to note that not all women with implants experience symptoms or become sick. Some women with implants, and the percentage is unknown, do experience a range of autoimmune disease symptoms such as joint pain, chronic fatigue, muscle pain or brain fog. Unfortunately, there is not a test to determine if the symptoms they are experiencing are related to their implants.

One of the things that makes BII so difficult to study, diagnose and treat, is that there is no definitive list of symptoms. BII is not a defined disease. The symptoms women experience, however, are very real. And while it can’t be confirmed through a test or a checklist, sick women understandably want to know if their breast implants are causing the symptoms they are experiencing.

In many cases they have already been to see other doctors to rule out rheumatologic diseases or infections, and they have reached the end of their rope. “These women feel bad. That’s not pretend,” points out Dr. Haws. “Whether it’s the implants or not – we may not know. But, they do feel bad. The symptoms are real.”

If there is no way to know for certain if the implants are causing the illness, what can be done? The surgical option is to remove the implants and see if the symptoms are alleviated or cured as a result.

“What we do is elective,” explains Haws. “People choose to get breast implants, and by the same token, you can choose to get your implants out. Unless you have some medical reason for me not to operate on you, there’s no reason for me not to take your implants out if you want them out.”

Unfortunately, Dr. Kessman points out, not all surgeons are willing to listen to patients’ concerns about their implants. “People are going to their surgeons, explaining their symptoms,” says Kessman. “Surgeons are telling them they aren’t related to their implants. Then they are going online and finding information [that says otherwise].”

Not All Information is Good Information

While there is some very helpful information online, as on The Plastic Surgery Channel website, there is also some very misleading and downright scary information that can be found on the Internet.

“I always tell patients, if you see something that scares you, if you see something on the news, call us before you worry,” emphasizes Dr. McGuire. “We can tell you if it is crazy or if it is real. Be careful where you get your information.”

The real news surrounding breast implants and health is constantly evolving. In the past decade surgeons have learned that capsular contracture, the hardening of the scar tissue around the implant, can occur as the result of bacterial contamination, which then sets off an immune response. In the past five years surgeons have also learned of the connection between BIA-ALCL, a lymphoma of the immune system, and breast implants.

It is important for patients to stay in contact with their plastic surgeons so that they can stay informed of the latest developments in breast implant health news.

Find A Plastic Surgeon Who Will Take Good Care of You

Women experiencing possible BII symptoms who have been turned away by one plastic surgeon may find themselves on the hunt for one who will care for them. While there is not currently a nationwide list of plastic surgeons who routinely care for BII patients, Dr. Haws and Dr. McGuire provide the group with helpful suggestions for ways to screen potential plastic surgery practices over the phone.

“You have to be careful,” cautions McGuire. “There are plastic surgeons out there who will say, ‘Oh, you have a symptom? We’re not even going to look at you. We’ll just take your implants out.’ And there are other ones who won’t do it at all.”

“First, look at their website,” says Haws. “Do you like the kind of work they do? Are they board certified? Then you call. Most good plastic surgeons have a patient care coordinator who takes that call. It’s not just a busy receptionist.  You can just ask these questions:

• Does your doctor see BII patients?
• Do you take out capsules if I request it?
• Will you do testing?”

“If whoever answers the phone can’t answer your questions, don’t go there,” emphasizes McGuire. “They should be educated on it.”