- Thousands of women have spoken out about breast implants that have led to excruciating pain, immobility, full-body rashes, and unrelenting nausea. The cluster of symptoms has been dubbed breast-implant illness.
- The condition is not an official medical diagnosis and doctors have been unable to find evidence it exists, and the plastic-surgery community at large has continued to operate as usual.
- But four known plastic surgeons in the US are no longer comfortable giving breast implants and have removed the offering from their practices.
- Visit Insider’s homepage for more.
After breastfeeding her three sons, 40-year-old Susan Barrow wanted her breasts to look perky again.
She first thought she wanted a breast lift, which involves surgically removing excess skin and reshaping the breasts, but the plastic surgeons she consulted with convinced her a breast augmentation would better help achieve her goals. The procedure requires a surgeon to insert silicone or saline-filled implants into the breasts to create a fuller appearance.
Just a week following the surgery in which Barrow had her breasts enlarged with implants, she was unable to sleep on her left side because the devices made the experience excruciatingly painful.
That pain persisted for years. Soon, it was accompanied by other symptoms that felt even worse. “My body would swell up and get rashes out of nowhere. I saw every type of doctor possible and no one gave me an answer,” said Barrow, a mortgage lender in Washington state.
In 2018, 11 years after getting her implants, Barrow hit a breaking point. She felt so weak that she stayed in bed for two weeks straight and her hair began to fall out in chunks. “It felt like I was fighting for my life every day,” she said.
Barrow’s story is one of thousands, but the medical community is slow to change
Barrow is one of thousands of women who have spoken out, either at at a spring Food and Drug Administration hearing or online, about breast implants that have led to excruciating pain, immobility, full-body rashes, and unrelenting nausea.
There are more than 250 online groups, pages, and communities dedicated to supporting women with the issue, according to one advocacy organization’s running list. One group alone has more than 96,000 members.
But doctors haven’t been able to find medical evidence that the cluster of symptoms known as “breast-implant illness” exists, and so the plastic-surgery community at large continues to operate as usual.
A handful of plastic surgeons in the US are bucking the trend, however, and refusing to offer breast implants in an effort to protect future patients from the elusive illness.
Board-certified plastic surgeon Dr. Jae Chun of Newport Beach, California, is among them. “You can’t predict who will have issues and who won’t, so I didn’t feel comfortable putting them in at all,” he told Insider.
Reports of a mysterious ‘breast-implant illness’ can be traced to the 1990s
Breast-implant illness was first publicized in 1990, when the journalist Connie Chung shared stories of women who said they had a mysterious “breast-implant illness” on a CBS broadcast. At the time, plastic surgeons criticized Chung’s reporting, calling it fearmongering because it lacked scientific evidence.
Still, the report got people talking, especially women who’d experienced nausea, fatigue, and vomiting after getting implants. Some of them began seeking explants, a surgical procedure that involves removing the implants and surrounding scar tissue.
According to Chun, Chung’s reporting and the rise of social media propelled his explant-surgery business into what it is today.
“Strangers around the world are exchanging their stories and finding commonality,” Chun previously told Insider. “Women taking them out are saying, ‘I feel better with them out’ after being told it was menopause or nothing to do with implants.”
He suspects some women react to silicone the same way some people are allergic to penicillin. “A certain percentage [of people] just can’t tolerate those materials because their body can’t take them,” he said.
Breast-implant illness gained more attention after a kind of implant was linked to cancer
In March, nearly three decades after Chung rang the alarm bell, the FDA held a hearing on the safety of breast implants. The hearing was unrelated to breast-implant illness; rather, it came after the FDA received hundreds of reports that women with breast implants had developed a rare form of cancer called breast-implant-associated anaplastic large-cell lymphoma, or BIA-ALCL.
The vast majority of BIA-ALCL cases were linked to Allergan’s textured Biocell implant. These implants have since been recalled, but the hearing directed attention to an uncomfortable fact: There’s a lot the medical community doesn’t know about the long-term effects of breast implants of any kind.
“It makes me question whether I should have gotten implants in the first place,” Kim Horner, a woman who has the recalled implants but no symptoms, previously told Insider.
A handful of plastic surgeons in the US have taken breast implants off the menu
Chun and Dr. Lu-Jean Feng are two of only a handful of known U.S. plastic surgeons who once offered breast implants but now completely opt out, according to Silvia Germek, who administers various support groups on Facebook for women with breast implant illness, including one with over 8,000 members called Breast Implant Illness Healing Warriors.
Feng, who owns a clinic in Pepper Pike, Ohio, began performing explant procedures in the 1990s, about the time of Chung’s CBS broadcast. Women were coming to her complaining of nausea, fatigue, inflammation, and other symptoms they believed were linked to their implants. Feng said most of her patients at the time came from law-firm referrals, as these women were filing class-action suits because of their symptoms.
As the years passed, Feng noticed more social-media-driven advocacy for women with breast-implant illness, and in early 2016, Feng explanted reality star Yolanda Foster’s breast implants on a season-six episode of “The Real Housewives of Beverly Hills.”
“Once they were removed, these foreign bodies, she felt a difference,” Feng told Insider about Foster’s improvement in symptoms like chronic pain.
Foster’s televised procedure generated a lot of publicity about breast-implant illness, Feng said, and more and more women came to her office seeking explants.
“It became clear to me at that time the illness is real,” Feng said. The women who want their implants removed, she added, have “no secondary gain. They have to come up with the funds to do this and give up on a result they love. It takes a lot of courage to come to the decision to get rid of the implants.”
In 2014, Feng completely stopped offering breast implants at her practice.
Dr. Frederic Barr of West Palm Beach, Florida, has done the same. “A lot of patients are coming in with stories and complaints,” he told Insider. “It’s a personal choice for me that says I have concerns and the science is yet to be done. There are a lot of open-ended questions need to get worked on and resolved.”
The surgeons who’ve opted out of breast-implant offerings say they still have robust practices
The few plastic surgeons who have eliminated their implant offerings said they haven’t suffered a significant loss of business.
Chun said his explant business has successfully replaced his implant business. He’s certain he’s removed the breast implants that various surgeons in his area have implanted, and that he’s even removed a number of implants he put in his own patients years ago.
“It’s not like the implants I put in aren’t part of the problem,” Chun said.
Feng uses other non-implant methods for breast augmentation, like a breast lift using fat from the stomach area. Still, there are downsides to this procedure. Dr. Alan Matarasso, president of the American Society of Plastic Surgeons, said the method can’t offer the same dramatic result as an implant, and the augmentations are also extremely invasive.
Most plastic surgeons continue to offer breast implants to their patients
The same lack of research that has led a few surgeons to abandon their breast-implant businesses is what other plastic surgeons cite as a reason to continue to offer the devices. Plus, the ubiquity of the symptoms makes it nearly impossible to rule out all other possible causes.
“There is no scientific research published in any credible medical journal that identifies a link between breast implants and any other generalized symptoms as described by some women online,” Dr. Daniel Maman, a board-certified plastic surgeon, told Shape magazine. “There are more people walking around with breast implants than any other medical device, including cardiac pacemakers, so if ‘breast implant illness’ was a cause for concern, we’d know about it already.”
Dr. Anne Peled, a board-certified plastic surgeon who specializes in breast-reconstructive procedures, told Insider most women with implants do well. “I can count on one hand women with symptoms they attribute to their implants. I think it’s important we take it seriously and study it, but still remember that.”
Peled said she’s concerned that increased chatter about breast-implant illness could demonize the devices and limit options for women who might want breast reconstruction after a mastectomy.
“We’re trying to do a better job to assess outcomes,” she said. “I personally think refusing to do breast augmentation or reconstruction is more extreme than needed with the data we have available.”
The American Society of Plastic Surgeons doesn’t have a stance on breast implant illness, but Matarasso said the organization is “concerned and speaks regularly with the FDA, women’s groups, and manufacturers about the potential for implants to cause a myriad of symptoms like joint pain and rashes.”
In the meantime, Matarasso said, it’s each surgeon’s responsibility to decide what’s best for patients and to have informed discussions with them about the risks and benefits of any plastic-surgery procedure.
“We don’t have an opinion on how surgeons do breast enlargements as long it’s safe and in the interest of patients,” he said.
Susan Barrow got her implants removed and felt immediate improvements
On January 22, Barrow had her breast implants removed, along with the scar tissue that had formed around the devices in the 12 years they were in her body. Chun performed Barrow’s explant procedure at his Newport Beach, California, practice.
Barrow told Insider she noticed immediate health improvements. “My eyes looked whiter and less swollen and I was less puffy in my face” a few days later, she said. Barrow added that in the months since her explant, her energy levels were the highest they’d been in a long time.
These days, she spends her time advocating for other women who say they have breast-implant illness. She said multiple women contact her weekly to discuss their struggles with the illness and seek Barrow’s advice.
“I encourage them that they’ll get through this,” Barrow said. She even goes with some of them to interview doctors. Until the broader plastic-surgery community changes course, many women with breast-implant illness find their best advocates are each other.
If you’re experiencing breast-implant illness and would like to discuss your story, contact Julia Naftulin at firstname.lastname@example.org.