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Breast Health - Procedures | November 24, 2021, 3:57 CST

Women Are Removing Their Breast Implants at Increased Rates

BII and other complications are leading to a major jump in explant surgeries, doctors say.
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Photography by David Heisler

According to the 2020 Plastic Surgery Statistics Report, there were 193,073 breast augmentations last year. While those numbers were significantly down from 2019 (by almost 100,000 cases), there was a rise in explant surgery—with 36,367 people opting to remove their implants. Doctors are also anecdotally reporting a major increase in explant surgery within their practices.

Celebrities and public figures are leading the charge, with people like Chrissy Teigen and former "Bachelorette" Clare Crawley publicly announcing their implant removals.

In October, influencer Jenna Crandall openly told her 299K followers on Instagram that she would be removing her Allergan silicone breast implants. After developing unexplained rashes, skin issues and an autoimmune disease, she realized many of her issues began after getting implants seven years ago. "Literally everything was off," she shared with her followers.

Two weeks after her explant surgery, she posted another Instagram photo, encouraging others struggling with the effects of breast implants to think about getting their implants removed. "They will look amazing and u won't be sick and you will still be beautiful," Crandall wrote. "In fact more beautiful because your inner glow will come back. Your body won't be busy fighting toxic and harmful heavy metals. I was scared too but now I'm on the other side."

After sharing her story, more women came forward in the comments about their own unexplained health issues, realizing it could be connected to their implants, too.

Crandall isn't the only one getting sick or speaking up about her breast implant illness (BII). Katie Bishop, a TikTok influencer and R.N., posted a similar story about how her implants made her sick. "Explanted after 10 years and it feels so good. Haven't taken a deep breath in a decade," she wrote on her viral TikTok video.

@katphishhbishh

explanted after 10 years and it feels so good: havnt taken a deep breath in a decade #bii #implants #chronicillness #ittybittycommitee

♬ No One Can Fix Me - Frawley

The body's response to breast implants

On September 29, 2020, the FDA issued a recommendation, asking doctors and manufacturers to disclose breast implant risks to prospective patients.

Those risks may include:

  • Complications with breastfeeding
  • Systemic symptoms, such as brain fog, fatigue and joint pain (known as breast implant illness, or BII)
  • Connective tissue disease
  • Breast Implant Associated Anaplastic Large Cell Lymphoma (cancer of the immune system)

"Breast implants are a foreign body that prompt an immune response in the body, and the body tries to protect itself from the implant by creating a capsule around the implant as a barrier," explained Constance M. Chen, M.D., a board-certified plastic surgeon and breast reconstruction specialist. "Thus, most of the diseases caused by breast implants are due to the immune responses it provokes.

"For example," continued Chen, "the most significant disease caused by breast implants is Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a cancer of the immune system that has led to 33 deaths worldwide."

Alexander Zuriarrain, M.D., a double board-certified plastic surgeon with Zuri Plastic Surgery, also noted the risk of BIA-ALCL. "This is directly linked to the texturization process of certain implants that are no longer being used," he explained. "These types of implants were recalled and at this point, the implants that are recommended are smooth surface implants."

Chen said various studies have described an increased incidence of autoimmune diseases in women with breast implants—especially silicone breast implants—although causation has not been proven. Even so, all patients should review the FDA's warning to educate themselves about the risks of breast implants.

Other risks associated with silicone implants

The most common confirmed risk associated with breast implants is an infection that can occur after surgery. "In general, this is less than a 1 percent chance," Zuriarrain said. "It is very uncommon and in general quite rare. It can require removal of the implant if the infection were to progress, but this is unlikely."

Another possible risk associated with breast implants is developing a hematoma after breast augmentation. "That would require evacuation of the blood with a return to the operating room," Zuriarrain stated. "On some occasions, the implant must be left out of the breast pocket and replaced at a future time. In other instances, the implant can be immediately replaced."

A long-term risk of breast implants is implant rupture. Saline implant rupture will be noticed immediately, with the breast quickly deflating. Silicone rupture, however, is often not as apparent because the gel leaks out slowly. It can then spread to other parts of the body and can form unconformable scar tissue.

"When using silicone implants, it is important to obtain MRI surveillance of the implants three years after it has been placed and every two years after that to ensure the silicone shell has not been damaged," Zuriarrain advised. "If it is found to have been damaged, it is a simple procedure under sedation anesthesia to have them removed and replaced if desired."

Other risks with breast implants include changes in nipple sensitivity and breast sensation and the creation of a capsular contracture (scar tissue that forms around the implant and squeezes). This can require a repeat surgery to remove the capsule and place a new implant.

It's worth noting that while these risks are very real, many women who undergo breast augmentation do not suffer these complications. If you are interested in breast implants, talk to your doctor about the potential risks associated with the surgery.