Implants or Explants? Is Breast Implant Illness a thing?

Image by: philippe Spitalier

Image by: philippe Spitalier

Breast implants are known to be one of the top cosmetic surgeries performed worldwide, and many women opt for implants for many different reasons. Whether reconstructive or cosmetic, most ladies who take this step do so for positive transformation. So that’s why here at BioVitality, when the subject of Implant complications, namely Breast Implant Illness (BII), kept popping up all over our wellbeing channels online and off - we had to dive deeper to find out more. So what is Breast Implant Illness? Well, that’s where it can be a bit of a grey area. While the verdict is still out with some doctors who won’t and don’t acknowledge BII as a diagnosable disease - there are some doctors along with scientists who actively explore ways to learn if breast implants are triggering symptoms reported such as hair loss, fertility issues, Depression, Anxiety, joint and muscle pain, and brain fog to name a few. Our research on this topic shows that many women experiencing genuine symptoms feel a direct link between their symptoms and their breast implants. We wanted to chat with a professional who is not only for breast implants but who also recognizes and is actively open to searching for solutions for affected women dealing with symptoms associated with breast implant illness. We turned to the incredible Dr. Joan Monaco, MD, a plastic, reconstructive and cosmetic surgeon based in New York City

Get to know how Dr. JoAn saves her skin, her secret to her success and how she unwinds here: MARIA’S INNER CIRCLE: 5 minutes with plastic, reconstructive and cosmetic surgeon Dr. Joan Monaco, MD

Q. According to breastcancer.org, about 1 in 8 American women (about 12%) will develop invasive breast cancer during their lifetime. Any advice for women about maintaining breast health?

A. I'm adamant about breast health for myself, my patients, friends, and sisters. Monthly self-exams, routine mammograms, and MRIs. Every doctor has a different routine depending on a woman's risk factors and breast density. Not every person may need an MRI every year, nor are ultrasounds always needed by everyone every six months. So, for breast cancer screening, I always defer to the breast cancer experts to create the correct screening protocol for their patients, and I help the women in my life stick to these protocols.

Q. As a surgeon, have you noticed a change in demand for breast implants recently? 

A. Patients are coming in more than ever to take care of themselves during the pandemic. I don't know if it's working from home and being on zoom all day long, but self-care has become a priority in 2021, which is impressive. Patients are interested in breast augmentation in record numbers, but I also see an increased number of patients interested in breast implant removal. I don't know if it's the media or the pandemic or simply more information in the press about breast implant illness that's motivating women to remove their breast implants as often as new patients want breast augmentation surgery. I have a cautious consultation conversation with every patient about their breast augmentation goals or breast implant removal. The patient and I are on the same page about the risks and benefits of any breast surgery.

Q. Do any trends standout for you within the world of implants currently?

A. We have better implants today than ever before. Breast implants feel and look super natural when appropriately done that women are falling in love with their results. The trend right now is for very natural-looking breast augmentation. My patients are everyday people who are seeking breast augmentation to feel better in clothing but also people who want to preserve their familiar appearance instead of making a statement with new breasts. So, in my practice, the natural look is my signature to all breast surgeries.


Q. Any tips for women wanting to do implants and ways they can keep their implants' health at their peak?

A.  First, I make sure that every patient has a baseline mammogram to ensure that their breasts are healthy before proceeding with breast surgery.

Second, I make sure that patients take time to decide what size they want to be. Sometimes this takes two or three visits to my office to try on implants as I think computer software that shows simulated images of a patient's new breasts can be very misleading. I suggest that patients bring a tight-fitting sports bra to their consultation to see how they look with clothes on with their implant and even this technique is not entirely accurate. I also let patients take implants home to try them on, feel their weight and come back to discuss their size. Thirdly, I make sure patients are meticulous about following my post-op instructions, what type of bra to wear, their exercise routine, their follow-up appointments, and MRIs every few years to make sure their implants are intact.

Q. What are your thoughts on the 'Breast Implant Illness' (#BII) movement?

A.  As increased information gets presented about Breast Implant Illness, more patients realize that they might have symptoms after their breast augmentation that fit this movement. I believe that Breast Implant Illness is a genuine disease entity, rare, but it is accurate. I am exceptionally cautious when consulting with patients who want their implants out because I don't want them to have any regrets. Is it possible to remove a set of breast implants, and the symptoms of pain, fatigue, skin rashes will persist, even after removal. So, my patients must understand that sometimes removing their implants will not improve their symptoms. It's about setting and managing realistic expectations.

Q. What are the main deciding factors when women opt for explants?  

A. The number of women in my practice wanting their breast implants removed has increased in recent years. I think the word has gotten out that I am realistic and reasonable about breast implant illness, and I believe that removing their implants will resolve some if not all of the symptoms that cause their bodies not to feel right. I think doctors have gotten better about diagnosing auto-immune diseases and other ailments that present with a varied list of sometimes vague or misunderstood symptoms as we did not understand breast implant illness. I feel we still have a long way to understand why some women experience breast augmentation surgery symptoms.


Q. Any risks associated with explants that women should consider before doing it?

A. The risks of removing breast implants are usually limited to the surgery itself. There is always a minimal risk from anesthesia, blood clots, bleeding, infection, and well other less common risks with any surgery. I think women need to understand what their plan will be for removing their implants. Will they undergo a mastopexy or lift procedure? Will they want the fat transfer to the breasts to restore volume? When is the right timing for a post-surgery mammogram to keep their breast health at its best? There are options after breast implant removal that have to be considered at the time of the initial consultation so that both surgeon and patient are on the same page for the patient's path after explant.

Q. Lastly, what advice do you have for women considering explants?

A. I suggest that any woman considering breast implant removal list her symptoms and bring that list to her physician for a careful discussion. A knowledgeable physician with breast implant illness experience will examine other risk factors contributing to a patient's symptoms. Are there other medications or foods that are contributing to these symptoms? All options need exploring before proceeding with surgery in the name of breast implant illness. When this careful investigation gets done beforehand, patients will have the highest satisfaction after removing breast implants. 

[Sources]

https://www.health.harvard.edu/womens-health/could-your-breast-implants-be-making-you-sick

https://www.breastcancer.org/treatment/surgery/reconstruction/types/implants/special-report/breast-implant-illness

https://www.breastcancer.org/treatment/surgery/reconstruction/types/implants/special-report