Breast Implant Illness Treatment Asheville

While the risk of immediate surgical complications due to breast implant surgery is low — about 1% — some women experience a range of post-operative symptoms collectively known as breast implant illness, or BII. From fatigue and brain fog to rashes and joint pain, the many symptoms of this medical condition often lead to significant distress and decreased quality of life for patients.

Currently, very little research has been conducted regarding BII, leaving it poorly understood by doctors and patients alike. Without independently funded, rigorous scientific studies to guide clinical decision-making, we are left with differing opinions on how to approach and treat breast implant illness.

Despite a lack of scientific consensus, one fact remains: women are having real symptoms that may be related to their implants. They want to be heard, and they want treatment.

At Halvorson Plastic Surgery, our goal is to listen, offer resources, and develop a treatment plan built around you. If you are experiencing symptoms of BII and considering treatment, the surgical approaches we offer may help you find relief.

Schedule your consultation with the Halvorson Plastic Surgery team today.

What Is Breast Implant Illness?

Part of what has made studying breast implant illness so challenging is the lack of a formal, established definition of this condition. Without a definition or diagnostic criteria, we cannot determine how often BII occurs.

Amidst the lack of information, we do know that women have reported more than 100 symptoms related to BII, including but not limited to:

– Fatigue

– Memory loss (“brain fog”)

– Rashes

– Night sweats

– Hair loss

– Insomnia

– Anxiety

– Fibromyalgia

– Auto-immune disorders

– Joint pain

These symptoms are often hard to measure with tests and can take years to develop. In addition, they may take time to resolve after implant removal. As such, no one has a checklist or working definition of this problem, and this is why some doctors won’t recognize BII, whereas others work to study and define it.

(Learn more about breast implant illness in a blog post we recently wrote here.)

Causes of Breast Implant Illness

Currently, experts aren’t sure what the pathophysiological mechanism might be behind BII.

It is assumed BII is caused by a negative immunological reaction to silicone, but there is still no definitive evidence. While silicone particles can sometimes be found in a patient’s lymph nodes after an implant is placed, this doesn’t seem to have an impact on most who have this procedure.

But for some, the presence of silicone can cause other physiological and emotional responses.

BII can happen to patients who choose silicone (filled with silicone gel) or saline (filled with salt water) implants because both of these devices use a silicone shell.

Diagnosing Breast Implant Illness

Currently, there are no definitive tests to detect or diagnose breast implant illness. However, there is a series of preoperative and intraoperative tests that can be done to better understand the body’s processes and reactions to the implants.

Though these tests are not diagnostic for BII and usually do not change surgical decision-making, our team can order a variety of different tests:

– Preoperative tests: These evaluate implant integrity and measure your body’s immunologic reaction to a foreign object like a breast implant. Testing may include an MRI, Ultrasound, CBC, ESR, CRP, or ANA.

– Intraoperative tests: These may aid in the treatment of breast implant illness if an infection is detected or some other pathologic process. Testing may include pathologic analysis of the capsule and culture swabs of the implant pocket and/or implant saline to test for aerobic, anaerobic, fungal, and/or acid-fast bacilli cultures. We are also happy to offer implant processing for return to the patient.

While we don’t think such tests are crucial when evaluating and treating BII, some patients are curious about what these tests might show and how their bodies might change with surgery. Because our goal is to provide you with honest, evidence-based, and patient-centered care, we are happy to help you obtain and interpret such tests upon request.

Treating BII

While most patients are so unhappy that they are willing to undergo implant/capsule removal to see if it helps, the truth is that some patients may see no benefit from surgery. However, if your symptoms arose soon after implantation and are consistent with BII, then surgery could be your best option.

While scientific studies have not determined the best surgical approach, we recommend considering capsulectomy when treating BII. Capsulectomy can take one of three forms:

En-bloc capsulectomy: removal of the implant with its surrounding capsule intact as one piece
Total capsulectomy: removal of the implant and all of the surrounding capsule
Partial capsulectomy: removal of some or most but not all of the capsule

Capsules come in a variety of forms and may impact the kind of approach needed. What may be right for one patient may not be the best option for another. While en-bloc capsulectomy may make sense for a densely calcified and contracted capsule, it may not make sense for a thin, supple, translucent capsule that is adherent to muscle and blood vessels in a patient with small breasts, large implants, and no desire for the longer incision required.

Because there are no studies that have compared en-bloc, total, partial, and no capsulectomy in the treatment of BII, we do not know if symptoms will improve with implant removal alone vs. implant removal and capsulectomy. Early data from an ongoing study suggests that capsulectomy may not be necessary for patients with soft intact implants and healthy, thin capsules. Despite the lack of data, my approach is to consider what makes sense and is reasonable for you, depending on your anatomy, situation, and goals as an individual patient.

Surgery is performed in our office-based AAAASF-certified ambulatory surgery center with an MD anesthesiologist and experienced nursing and/or staff. Procedures offered include:

En-bloc capsulectomy
Total capsulectomy
Mastopexy
Fat grafting
Breast reduction

In addition to surgery, some patients may benefit from a detoxification protocol, a regimen designed to rid the body of toxins. We are happy to refer patients to a local naturopathic doctor for this. This may comprise dietary changes, supplements, cleanses, etc. Some patients follow detox protocols after implant removal, though there is no guarantee they will help resolve symptoms.

After your surgery, post-operative care is included. We usually see our patients 1 week after surgery (or the day after if they are traveling and spending the night in Asheville), 1 month later, 3 months later, and any time thereafter.

Recovery is generally 1-2 weeks out of work, and final results can be seen after 3 months.

(Learn more about Dr. Halvorson’s patient-centered approach to plastic surgery.)

What Does Halvorson Plastic Surgery Offer?

Our primary goal is to offer care that is honest, evidence-based, and patient-centered.

Although there are no definitive tests for BII, we can order the following tests:

- Preoperative Testing: MRI, Ultrasound, CBC, ESR, CRP, ANA
- Intraoperative Testing: Pathologic analysis of capsule, microbiology culture (aerobic, anaerobic, mycobacterial, acid-fast bacilli), implants processed and returned

Surgery is performed in our office-based AAAASF-certified ambulatory surgery center with an MD anesthesiologist and experienced nursing and OR staff. Procedures offered include:

- - En-bloc capsulectomy
  - Total capsulectomy
  - Mastopexy
  - Fat grafting
  - Breast reduction

Post-operative care is included. We usually see our patients 1 week after surgery (or day after if they are traveling and spending the night in Asheville), 1 month later, and 3 months later. Recovery is generally 1-2 weeks out of work but you will not see the final result until at least 3 months

The Halvorson Plastic Surgery Process

For too long, patients with the symptoms of breast implant illness have been ignored and dismissed by members of the medical community, including some plastic surgeons.

However, one thing is clear to me: BII is real for patients and, in many cases, improves with implant removal.

When you visit Halvorson Plastic Surgery for BII, we’ll work with you to develop a personalized treatment plan that makes sense to you and, most importantly, prioritizes your individual situation, preferences, and safety.

Schedule a consultation with us today to learn more about treating your breast implant illness in Asheville, NC.

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