The Diagnosis and Management of Patients With Findings Consistent With a Breast Implant Associated-Somatic Symptom Disorder (BIA-SSD)

Abstract

Background: Psychological factors seem to play a significant role in the perception and magnification of somatic symptoms in patients with breast implant illness (BII). Further, recent studies have shown that some patients with self-reported BII have findings consistent with a breast implant-associated somatic symptom disorder (BIA-SSD). The aim of this work was to provide guidelines for the diagnosis and treatment of BIA-SSD.

Methods: Findings from the current literature combined with both surgical and psychological therapeutic principles were used to develop methods for diagnosing and managing patients with BIA-SSD.

Results: Algorithms for the diagnosis of SSD associated with breast implants, as well as treatment options, are presented so that plastic surgeons can identify, counsel, diagnose, and offer treatment to patients with BII and findings consistent with BIA-SSD.

Conclusions: Plastic surgeons are in a unique position to identify self-reported BII patients with signs of BIA-SSD and offer help in navigating treatment options. In addition to providing information to patients about somatic symptoms and breast implants, surgeons should refer patients for a medical workup to rule out medical causes of symptoms. For patients with symptoms and a desire to maintain breast implants, referral to a qualified mental health professional trained in SSD therapy may be beneficial. For patients desiring removal of their implants for BII symptoms, explantation with the most conservative possible procedure is recommended.

Fig. 1.

Flowchart for the diagnosis of patients with a history of breast implant surgery and somatic symptoms they feel are related to their implants.

Fig. 2.

Flowchart for the treatment of patients with a history of breast implant surgery and somatic symptoms they feel are related to their implants.