Doctors insist breast implants are safe—but can thousands of women be wrong about their symptoms?

By Faith Brar
February 07, 2019

Shutterstock / Kpakook

Seven years ago, fitness influencer and founder of Diary of a Fit Mommy, Sia Cooper, made the decision to get silicone-based breast implants. "I thought they would make me happy, I thought they would make me look better," Cooper shared in a recent video on her YouTube channel.

But recently, the mother of two decided to get her implants removed after experiencing a plethora of strange symptoms that have caused her health to decline over the past couple of years. (Related: This Fit Mom Is On a Mission to Prove That EVERYONE Jiggles In a Bikini)

"About two years after getting my implants, I noticed a change in my health," Cooper tells Shape exclusively. "I started getting more and more tired by the end of each day. My hair started to fall out. I started getting headaches, which was new to me. But I chalked it all up to being a new mom at the time."

After undergoing a series of tests and consulting several doctors, Cooper still wasn't able to figure out what was wrong with her. "It wasn't until this year that my overall health seemed to plummet," she says. "I've been sleeping 12 hours a night and napping for about two hours in the afternoon to function. I'm active. I'm a fitness professional who shares her experiences with more than 1.2 million people every day. The level of exhaustion doesn't line up with consistently prioritizing what I deem 'no-pressure' healthy lifestyle habits."

What Is Breast Implant Illness?

Then, after sharing some of her symptoms with her followers, Cooper, who is also a former nurse, learned about "breast implant illness"-a term used by women to describe a series of symptoms that stem from ruptured breast implants or an allergy to the product, amongst other things.

"Lucky for those of us who've been struggling with this, there is a website and even a Facebook page about breast implant illness," says Cooper. "Over 50,000 women on these pages have been experiencing the same symptoms as mine while having their blood tests come back completely normal."

While Cooper never received a diagnosis of any kind, she was overwhelmed by her symptoms, and ultimately decided to get her implants removed. Following the hour and a half long procedure, she learned that she wasn't suffering from a rupture but had other issues with her implants. "[My doctor] was able to get all of my capsules out and said that the capsules went to my armpits and stuck on a blood vessel, which was scary...No leaks or ruptures thankfully," she said. "How do I feel? Slightly groggy, but happy. When I woke up in the recovery room the number one thing I felt was lighter and I could breath deeper. It no longer felt an elephant sitting on my chest. I look forward to seeing what symptoms improve and what stays the same."

But Sia isn't the only one who's opened up about how implants have caused all sorts of inexplicable health issues.

Australian fitness diva Jaz Correll recently shared that she decided to remove her implants after experiencing symptoms similar to Cooper's.

"I chose to remove my breast implants after 18 months of feeling average and not my best," she wrote on Instagram. "During this time I was suffering from what's commonly known as 'breast implant illness (BII).' Basically, my body and immune system [were] constantly trying to fight the implants. This constant fight made me extremely tired and left [me] susceptible to many other health issues ranging from viral infections to hair loss."

After getting her implants removed, Correll felt her body go back to normal. "I feel less inflamed and generally healthier now," she wrote. "Life without implants feels so good!" (Related: Getting Rid of My Breast Implants After a Double Mastectomy Finally Helped Me Reclaim My Body)

Fitness coach and influencer Emily Duncan did the same and has shared how her health improved significantly after getting explants as well.

"There are still people out there who think getting your implants taken out is just a 'trend,'" she shared in a post to her 200,000+ followers. "If that's you, I highly encourage you to open your mind. You don't know what someone else is going through. There's also a good bit of research out there regarding potential complications from breast implants. Will it happen to everyone? Not necessarily. But that doesn't discount the experiences of hundreds of thousands of women who have gotten very sick to deathly ill (some re-wrote their wills bc they thought they were dying)." (Related: 6 Things I Learned From My Botched Boob Job)

What Do Experts Think About Breast Implant Illness?

Regardless of all this anecdotal evidence, there are differing opinions among experts as to whether BII even exists. Many practicing plastic surgeons see little quantifiable evidence to support the claims of women like Cooper, Correll, and Duncan.

"There is no scientific research published in any credible medical journal that identifies a link between breast implants and any other generalized symptoms as described by some women online," Daniel Maman, M.D., a Harvard fellowship-trained and board-certified plastic surgeon tells Shape. "There are more people walking around with breast implants than any other medical device, including cardiac pacemakers, so if 'breast implant illness' was a cause for concern, we'd know about it already."

Rian Maercks, M.D., a leading aesthetic, craniofacial, and reconstructive plastic surgeon, mirrored Dr. Maman's thoughts: "The only illness to be associated with breast implants today is Anaplastic Large Cell Lymphoma," Also known as ALCL, this is an immune system cell cancer, which is extremely rare but has been found in a small number of women who had breast implant surgery.

"This illness is associated with specific implant textures and shells," says Dr. Maercks, "but no other infectious illnesses have been linked to breast implants."

Neither of the experts, however, completely discount the possibility that women could experience a series of reactions and complications as a result of breast implants. The FDA itself lists 26 potential complications (!) from the procedure, including lymphedema or lymphadenopathy, and toxic shock syndrome.

"There is a chance, though a low one, that a woman could have a reaction to her implants because a person can have a reaction to literally any substance," says Dr. Maman. "But considering the number of women receiving breast implants as compared to the number reporting this mysterious illness-it just doesn't seem to add up."

Dr. Maercks also clarified that: "As with any surgery, bleeding, infection, and unfavorable scarring are all possible, along with the risk of leaking as well. Symptoms such as headaches and lethargy can certainly happen if there's a subclinical or clinical infection, but otherwise those do not typically happen."

Some Common Misconceptions About Breast Implant Illness

The kind of leaking or infection Dr. Maercks is referring to, though, isn't as common as some might think. In fact, Dr. Maman says the risk of an implant randomly "popping" is 0.1 percent or less. "Implants don't just spontaneously rupture," he says. "But as I always tell my patients, breast implants are a mechanical device so there's always a risk of failure, just like a car tire."

To further explain, Dr. Maman used a hypothetical: "If you're driving your car down a highway, the risk that there's a spontaneous rupture is exceedingly low. You usually have to hit a nail or have some sort of accident that would cause the tire to pop. The same is true with breast implants. They won't just 'pop' or 'explode' without a reason, and if they do, it's exceedingly rare."

There are also a lot of misconceptions about the fact that if or when breast implants rupture, they begin leaking silicone and other substances into your body. "If you cut an implant open, it doesn't just leak onto the floor, it maintains its shape," clarifies Dr. Maman. "So in the case that an implant does rupture, it remains in the breast pocket and doesn't migrate."

Not only that, but Dr. Maman explains that patients who do have ruptured implants tend to be completely asymptomatic. Because the gel maintains its shape, patients' breasts don't usually look or feel any different either. "The most common way we find out that a patient's implant has ruptured is if they've been in for another procedure like an MRI, where we're able to see that the implant has been damaged," explains Dr. Maman. "Most of the time, patients have no idea that their implants have ruptured until they come in for an exam or consult."

New Game-Changing Evidence for Breast Implant Illness

Plastic surgeons at the University of Texas MD Anderson Cancer Center have just published the largest study of silicone gel implants since 2006. Using data from close to 100,000 patients and a secondary analysis of data gathered from an FDA database, researchers concluded that breast implants are in fact associated with a higher incidence of certain medical conditions.

Compared with normative data, silicone implants are associated with higher rates of Sjögren syndrome (an immune system disorder characterized by dry eyes and dry mouth), scleroderma (a group of chronic, rare diseases that involve the hardening and tightening of the skin and connective tissues), rheumatoid arthritis, stillbirth, and melanoma, the study notes.

However, according to many people in the plastic surgery community-including Dr. Maercks-the study shouldn't be taken at face value. "This is a study compiled from several other studies that were assembled in different ways, so you have to consider that they were conducted differently," he says. Dr. Maercks added that secondary analysis studies (aka studies about other studies) aren't always the most credible. While they're a great way to identify patterns and trends, usually a lot more research is required before drawing any definitive conclusions.

The FDA itself has been quick to fire back and take a stand against the study's findings. "We respectfully disagree with the authors' conclusions," said Binita Ashar, M.D., and director of the agency's Division of Surgical Devices in a press release. Similar to Dr. Maercks, Dr. Ashar cited concerns such as poor study methodology and potential sources of bias. She advised the public and health-care community to take the study's findings with a grain of salt.

That being said, this study, along with several other claims about the risks of breast implants, is pushing the FDA to hold a public meeting in 2019. They want "to ensure that patients and health-care providers continue to have accurate, scientifically sound information about breast-implant safety and effectiveness." By providing a platform for people to share their concerns they, "hope to promote public dialogue on the issue."

Should You Reconsider Breast Implants?

The short answer? We don't know.

Whether breast implant illness is a real phenomenon or not, it's clear that more detailed research needs to be done on breast implants and their effects on the body. While a lot of experts still seem to hold their ground and claim that breast implants are generally safe, there's no denying the latest shocking admission from the FDA: The org just released a report saying a rare but deadly form of cancer has been linked to breast implants.

At least 457 (!) women in the United States have been diagnosed with anaplastic large cell lymphoma, a type of cancer that affects cells in the immune system and can be found around the breast implant. Of those women, nine have died, according to a statement by the FDA.

While women without breast implants can still develop anaplastic large cell lymphoma, the FDA warns that, yes, women with breast implants are at an increased risk. "We hope that this information prompts providers and patients to have important, informed conversations about breast implants," they said. (Before going under the knife, read 12 things plastic surgeons wish they could tell you.)

So it's worth remembering that getting breast implants is a surgical procedure that introduces something foreign to your body. Breast augmentation is the most common plastic surgery procedure in the country, with more than 300,000 performed in 2017 alone, according to a report by the American Society of Plastic Surgeons. But just because it's common doesn't mean it's NBD. Surgeries inherently present the risk of a plethora of potential complications. Talk to your plastic surgeon and educate yourself on the risks involved before making a final decision.

If you have implants already and are currently experiencing unexplained health symptoms, be sure to reach out to your doctor, and get a second opinion if necessary. Listen to your body and remember that, ultimately, it's all about what makes you feel your best.