Breast Implant Illness

What Causes Breast Implant Illness?

Saline and silicone breast implants are medical devices, and although they are FDA approved for safety, they can occasionally develop issues such as ruptures or silicone leakage. The human body can also have an autoimmune reaction called Human Adjuvant Disease to foreign bodies and this can be an underlying cause of breast implant illness. Breast implants can also become contaminated by biofilms (a collection of microorganisms, such as bacteria, that can grow on a surface); this can occur from the initial placement or from contamination at a later date, like during pregnancy or breastfeeding (period when the breasts may have a higher bacterial load).

Breast Implant Illness From Silicone Implant Leakage

When breast implants get old, the silicone can rupture. The ruptured silicone usually remains contained within the capsule, however, it can spread through the lymphatic system to other parts of the surrounding breast, muscle, and lymph nodes. Silicone is nonreactive in most people, but can cause inflammation, granulomas, and calcifications in sensitive individuals. To correct this, the free silicone, tissue surrounding it, and the leaked silicone are removed to maximize the reduction of silicone particles and help prevent any future reactivity, which includes the capsule. Silicone can also spread to local lymph nodes in the axilla. Dr. Cassileth does not recommend removal of lymph nodes with silicone unless they are symptomatic.

Breast Implant Illness from Biofilm

Breast implant illness from biofilm occurs when the surface of the implant comes into contact with a bacteria that can cause biofilms. Biofilms stick to the implant and are embedded within an extracellular matrix that is composed of extracellular polymeric substances. Unfortunately, the bacteria that can cause biofilms are present on our skin, in the ducts of the breast, and can proliferate during breastfeeding. If these bacteria contaminate the surface of the implant, they can populate the surface of the implant, and cause unwanted inflammation and autoimmune symptoms. To make the process even more complicated, biofilms can be present without inflammation. They can also be hard to grow out of culture, and therefore hard to diagnose. For that reason, Dr. Cassileth recommends every patient have a PCR test performed on their capsule and implant surface (to help determine the type of biofilm) as well as the usual microbiological specimen. If breast implant illness is from biofilms, the removal of the capsule and the implant is necessary.