Dr. Jeffrey Lee is a Harvard-trained plastic surgeon serving patients in the greater Boston area. He specializes in cosmetic procedures of the face, breast, body, as well as nonsurgical treatments such as Botox and Juvederm. After medical school, he completed his training in surgery at Massachusetts General Hospital, a Harvard Medical School hospital. During this time, he also completed a fellowship in the Plastic Surgery Research Lab where he published numerous book chapters and journal articles. He also traveled extensively giving presentations at the national and international level advancing the field of plastic surgery. Haute Beauty chats with Dr. Jeffrey Lee to learn more about breast implant illness (BII), which is an autoimmune/inflammatory syndrome — inducing a range of troubling symptoms—that can occur after experiencing reconstruction or cosmetic augmentation with breast implants.
Haute Beauty: What are the most common symptoms of BII and are they the same for all sufferers? How should sufferers lessen the impact and severity of these symptoms?
The most common symptoms are rash, GI symptoms, a feeling of fogginess, and joint pains. Treatment of the symptoms should be targeted toward treating the individual symptom or avoidance of triggers such as certain foods.
HB: What should you do if you suspect you have BII?
If you are having unexplained symptoms it is important to first see your primary care physician. They will investigate the more common things and make sure it is not something more easily explained. From there, you should seek out a consultation with a plastic surgeon who is familiar with this problem.
HB: Why would individuals who have just undergone breast augmentation surgery experience this illness and these symptoms?
Unfortunately, there is no reason or patient type for BII. It is a rare problem and very difficult to diagnose. As we treat more patients, our understanding of the problem deepens but there is still a lot we do not know about this problem.
HB: Can it happen to anyone or is it indicative of a faulty job on the surgeon’s behalf? Or, is it a rejection of the implant material by the body?
It can happen to anyone with breast implants and there is nothing out there that relates to the surgeon or surgical technique used. For some reason, patients with BII react to the implants in a way that causes these symptoms and we still do not know why.
HB: How often is BII recognized and diagnosed? How can patients speculate and recognize this illness for themselves?
BII is really difficult to diagnose. Even when I see patients in consultation for BII, I tell them that removing the implants may still not resolve their symptoms. I have certainly removed implants with no change in the patient’s symptoms. I have also removed implants and seen a dramatic improvement even by the first week.
HB: What possible treatments and solutions exist for BII? Should implants be removed? How long after removal do symptoms subside?
Unfortunately, the only treatment is to remove the implants and see what happens. This is often difficult because patients usually love the way they look with their implants and giving them up may not change anything. Usually, patients have gone through many tests and doctor visits before they feel frustrated enough to seek out implant removal. At this point, patients also often choose to have a capsulectomy done, which is the removal of the tissue that surrounds the implant. One benefit of this is that we can send the tissue for pathology which can sometimes shed some light on the clinical situation. I tell all my patients that removing implants and/or the capsule may or may not change their symptoms but there is only one way to find out. In the patients I have seen improvements, I have seen it as early as the first week after surgery. I remember one of my patients telling me that she felt like a different person the very next day. I have also seen it take weeks/months for improvements so it really varies by patient.
HB: Is it safe for people who have suffered from BII to replace a removed implant with a new implant of an entirely different material?
It is possible to replace with different implants although most choose not to. Implants have come a long way and I do feel that the newer implants are better. In general, I do recommend removing the implants first and seeing what happens because that will give you an answer. From there, you can choose to get new implants either from a different company or different material with the knowledge that the symptoms may come back. In my experience, patients who get their implants removed for BII rarely get them to put back in.
HB: Does insurance cover implant removal?
Unfortunately, insurance companies do not yet recognize BII as a diagnosis. So they do not cover the treatments. We do have information on pricing on our website.
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