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. 2023 Sep 14;43(10):1194-1204.
doi: 10.1093/asj/sjad098.

Longevity of Post-Explantation Systemic Symptom Improvement and Potential Etiologies: Findings From the ASERF Systemic Symptoms in Women-Biospecimen Analysis Study: Part 4

Caroline Glicksman, Patricia McGuire, Marshall Kadin, Kirsten Barnes, Roger Wixtrom, Marisa Lawrence, Melinda Haws, Sarah Ferenz, C James Sung, Robert G Hamilton, Kate Faasse

Longevity of Post-Explantation Systemic Symptom Improvement and Potential Etiologies: Findings From the ASERF Systemic Symptoms in Women-Biospecimen Analysis Study: Part 4

Caroline Glicksman et al. Aesthet Surg J. .

Abstract

Background: Breast Implant Illness (BII) describes a variety of symptoms reported by patients with breast implants. Biospecimens data revealed minimal statistical differences between BII and non-BII cohorts. Baseline analysis of PROMIS data demonstrated significant differences between the BII cohort and the 2 control cohorts.

Objectives: This study was designed to determine if patients in the BII cohort obtained any symptom improvement after explantation, whether symptom improvement was related to the type of capsulectomy, and which symptoms improved.

Methods: A prospective blinded study enrolled 150 consecutive patients divided equally into 3 cohorts. Baseline demographic data and a systemic symptoms survey, including PROMIS validated questionnaires, were obtained at baseline, 3 to 6 weeks, 6 months, and 1 year.

Results: A total of 150 patients were enrolled between 2019 and 2021. Follow-up at 1 year included 94% of the BII cohort and 77% of non-BII and mastopexy cohorts. At 1 year, 88% of patients showed at least partial symptom improvement, with a reduction of 2 to 20 symptoms. The PROMIS score in the BII cohort decreased at 1 year for anxiety, sleep disturbances, and fatigue. Systemic symptom improvement was noted out to 1 year in the BII cohort regardless of the type of capsulectomy performed.

Conclusions: Parts 1-3 in this series concluded that there were no consistent differences in biospecimen results between the cohorts. Unlike the data observed in the biospecimen analysis, BII patients had heightened symptoms and poorer PROMIS scores at baseline compared to the control cohorts. The reduction of negative expectations and a potential nocebo effect could contribute to this improvement.

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Figures

Figure 1.
Figure 1.
Systemic symptoms reported by cohort. BII, breast implant illness.
Figure 2.
Figure 2.
Systemic symptoms: cohort by time interaction. BII, breast implant illness.
Figure 3.
Figure 3.
Systemic symptom improvement by capsulectomy type. Vertical axis represents average number of symptoms.
Figure 4.
Figure 4.
Cohort by time interaction for anxiety, cognitive function, fatigue, and sleep disturbance. BII, breast implant illness.
See this image and copyright information in PMC

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References

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