Self-Reported Breast Implant Illness: The Contribution of Systemic Illnesses and Other Factors to Patient Symptoms.

Patients with self-reported breast implant illness (BII) report a range of systemic symptoms which they attribute to having breast implants. The etiology of self-reported BII is unknown. Some patients have limited resolution of symptoms despite implant removal, and the mechanism of persistent symptoms is unclear. Notably, there are a number of prevalent, chronic systemic illnesses and other factors which present with the most common physical symptoms of self-reported BII. Fibromyalgia, chronic fatigue syndrome, autoimmune disorders, and hypothyroidism often produce fatigue, joint and muscle pain, "brain fog," anxiety or depression, and hair loss in affected patients who may or may not have breast implants. Other factors such as anxiety with or without depression, perimenopause, aging, cigarette smoking/marijuana use, and prominent side effects from common medications are known to produce similar symptoms as those reported by patients concerned with BII. The possibility that patients with breast implants have an undiagnosed, chronic illness unrelated to breast implants should be considered as well as other factors which may produce similar symptoms. Plastic surgeons should be aware of the range of illnesses and factors which can produce physical symptoms similar to those of patients with self-reported BII. For patients in which a systemic illness or other factor is felt to play a contributory role to self-reported BII symptoms, referral to an internist or rheumatologist for a thorough history and physical examination to rule out conditions may be prudent before explantation. This may reduce the need for explantation if the etiology of systemic symptoms is found to be unrelated to breast implants. Level of Evidence 3: