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. 2021 Sep 7;9(9):e3813.
doi: 10.1097/GOX.0000000000003813. eCollection 2021 Sep.

Outcomes of Implant Removal and Capsulectomy for Breast Implant Illness in 248 Patients

Jacob Y Katsnelson  1 , Joseph R Spaniol  2 , Joshua C Buinewicz  3 , Frederick V Ramsey  4 , Brian R Buinewicz  1   3
Affiliations

Outcomes of Implant Removal and Capsulectomy for Breast Implant Illness in 248 Patients

Jacob Y Katsnelson et al. Plast Reconstr Surg Glob Open. .

Abstract

Background: Breast implant illness (BII) is a term popularized by social media to describe systemic symptoms that patients ascribe to their breast implants. Though the concept of implants as an underlying cause for a systemic illness remains controversial, few studies have delineated the implant characteristics, capsular histology, and outcomes of patients who undergo explantation for BII.

Methods: We retrospectively reviewed the demographics, presenting symptoms, outcomes, capsular histology, and culture results of all women who presented to the senior author with symptoms attributed to BII and underwent breast implant removal with capsulectomy from August 2016 to February 2020. Chi-square and logistic regression analyses were performed to evaluate association between implant type, composition, and findings of inflammation on capsule pathology.

Results: Among 248 patients, 111 (23%) capsules demonstrated inflammatory changes on permanent pathology. Capsular inflammation was independently associated with silicone versus saline (right odds ratio [OR] = 2.18 [1.16-4.11], P = 0.016, left OR = 2.35 [1.08-5.12], P = 0.03) and textured versus smooth implants (right OR = 2.18 [1.16-4.11], P = 0.016, left OR = 2.25 [1.17-4.31], P = 0.01). Silicone material was present in the capsules of 12 patients (4.8%). Fourteen patients had positive cultures. There was one pneumothorax (0.4%), three hematomas requiring evacuation (1%), and two DVTs (0.8%). Of 228 patients, 206 (90.4%) reported high satisfaction with the outcome of the procedure.

Conclusions: In a large cohort of BII patients, we found that capsular inflammation is significantly associated with silicone and textured implants. Implant removal with capsulectomy can be safely performed in patients with BII with a low complication rate and high patient satisfaction.

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Conflict of interest statement

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Figures

Fig. 1.
Fig. 1.
Most common complaints reported by patients on initial evaluation.
Fig. 2.
Fig. 2.
Characteristics of removed implants. A, Make and model. B, Texture and fill.
Fig. 3.
Fig. 3.
Rates of inflammation by implant type. A, implant fill. B, implant texture.
Fig. 4.
Fig. 4.
Logistic regression modeling for ORs with regards to texturing and implant fill.
See this image and copyright information in PMC

References

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