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Evidence Based

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Understanding Breast Implant Illness: Symptoms, Risks, and Treatment

Written by Dr. Michael Ruscio, DC on May 2, 2025

Written by Dr. Michael Ruscio, DC on May 2, 2025 — Reviewed by Hannah Wright

• Breast Implant Illness|
• Symptoms|
• Prevalence|
• Breast Implants After 20 Years|
• Diagnosis|
• Management|
• Removal Considerations |

Sometime after getting breast implant surgery, many people develop a collection of symptoms, such as joint and muscle pain, brain fog, and fatigue. Since the 1980s, these symptoms have been attributed to the breast implants themselves 1.  

Breast implant illness isn’t yet recognized as a formal medical diagnosis. But just as with other chronic conditions, like leaky gut, that doesn’t mean the symptoms aren’t real. More likely, scientists have yet to understand the vague symptoms of inflammation that many people are experiencing for different reasons. 

Fortunately, integrative and functional medicine providers have much to offer when it comes to finding root causes of and healing the symptoms of breast implant illness. 

What Is Breast Implant Illness?

Breast implant surgery has been around since the early 1960s 1. People typically get breast enlargements to 2:

• Restore previous breast size after a mastectomy (breast removal) or other reductions in breast size
• Correct natural breast asymmetry
• Boost confidence   

Breast implants are FDA-approved medical devices, of which there are two primary types 3: 

• Saline breast implant: An outer silicone shell filled with sterile salt water 
• Silicone breast implant: An outer silicone shell filled with silicone gel 

Silicone gel-filled breast implants are now widely used in the U.S.—more than 300,000 people get them each year. Worldwide, they make up about 15% of all plastic surgeries 4.

In the 1980s and 1990s, many women reported health problems that developed after they got silicone breast implants. As a result, the FDA temporarily banned these implants from 1992–2006 4. More recently, these same health concerns have been recognized as breast implant illness (BII) 1.

BII involves a mix of body-wide and localized symptoms that affect some women with silicone breast implants. Many women feel better after having their implants removed, but experts still don’t fully understand why 5. 

Some researchers suggest BII could be caused by 4 5 6: 

• Ongoing inflammation from the body reacting to the implant
• Chemical leaks from silicone breaking down
• Other immune reactions to breast implants  
• Immune reactions to the surgical process  

Because doctors don’t all agree on what causes it, many believe that BII isn’t real 4. 

However, in recent years, more people with silicone breast implants have come forward with health problems, and more surgeons are listening to them. In fact, the U.S. Food and Drug Administration now recognizes a connection between breast implants and body-wide symptoms. 

I think it’s telling that more than 20,000 women have their implants removed each year, and many feel better after the removal 4.

What Are the Symptoms of Breast Implant Illness?

Breast implant illness can cause a wide range of symptoms. The most common include 6 7:

• Extreme or ongoing fatigue
• Joint pain
• Morning stiffness
• Muscle pain
• Brain fog
• Numbness or tingling in hands and feet
• Swollen lymph nodes
• Dry eyes, skin, and mouth

Other symptoms of breast implant illness may include 8: 

• Disrupted sleep 
• Depression 
• Anxiety 
• Autoimmune disease (e.g., multiple sclerosis, lupus, or Hashimoto’s thyroiditis)
• Muscle weakness 
• Fever 
• Night sweats 
• Headaches 
• Raynaud’s phenomenon (fingers or toes feel numb, cold, or change color in response to cold or stress)
• Allergy symptoms (runny nose, itchy eyes, red eyes, nasal congestion, or postnasal drip) 
• Nickel allergy 
• Multiple chemical sensitivity (things like perfumes, cleaning products, or cigarette smoke cause a headache, fatigue, dizziness, or trouble breathing) 
• Lung problems 
• Gastrointestinal symptoms (gas, bloating, changes in bowel habits, cramping, abdominal pain) 
• Interstitial cystitis (a condition causing bladder pain and pressure and an urgent need to pee)
• Skin rashes 
• Hair loss 

Symptoms of BII can begin at any time, but often appear 5–13 years after getting breast implants. Again, most people who have their breast implants removed are likely to feel better afterward 9.

How Common Is Breast Implant Illness?

If you’re experiencing symptoms of BII, you may be tempted to self-diagnose, but first let’s put breast implant illness in context. 

We don’t have official stats of how many people experience BII. It’s difficult to know how common breast implant illness is because it’s not a formal medical diagnosis that’s easy to track, but we have some evidence that can clue us in. 

Across 28 studies, roughly a third of people with breast implants reported symptoms associated with breast implant illness. And in 15 studies on implant removal, almost three-quarters of participants chose to remove their implants—and about 84% of them said their symptoms got better afterward 9.

Factors That Affect the Likelihood of Developing Breast Implant Illness

Not everyone with breast implants will experience breast implant illness, but anyone with implants can develop it 10.

In general, breast implants come with a long list of risks, such as 11:

• Breast pain
• Nipple or breast feeling different or going numb
• Changes to the shape of the chest wall
• Damage to the breast or nearby tissue 
• Infections
• Other health problems
• More surgeries to correct issues after getting or removing implants
• Hard scar tissue forming and squeezing the implant 
• Implants breaking or going flat
• Cancer associated with breast implants
• Trouble breastfeeding or not being able to breastfeed at all

We don’t know why some people develop breast implant illness and others don’t. Some research has found that more than half of people with BII had allergies when they got their implants, suggesting their immune systems could have been more reactive and responded badly to the implants 7. But it’s not clear yet whether allergies actually raise the risk. 

As I mentioned earlier, we don’t know what causes breast implant illness, but leading theories include 4:

• Ongoing inflammation – This could come from textured implants irritating the body or from bacteria around the implant.
• Chemical leaks – Over time, silicone in the implants can break down and release chemicals into the body. These might disrupt the immune system or cause other problems.

Another similar theory is that BII occurs when the immune system has an outsized reaction to the implants—and the chemicals in them—and produces a lot of inflammation that causes a wide variety of symptoms 5. 

What Happens to Breast Implants After 20 Years?

Breast implants do not last forever. Although some can stay intact for up to 20 years, they can begin to break down or stop working properly over time 12. The longer you have breast implants, the greater your risk of breast implant illness and other health problems 12. 

Signs that your breast implants may need to be removed or replaced include 12:

• Symptoms of breast implant illness (see above)
• A broken or leaking implant 
• Hard, painful breasts from scar tissue tightening around the implant (capsular contracture) 
• Changes in the shape or size of an implant
• Ongoing pain or discomfort, such as tingling, swelling, burning, or numbness around the breast
• Visible rippling under the skin

How to Find Out if You Have Breast Implant Illness

Unfortunately, there isn’t a test that identifies breast implant illness, and when symptoms occur months to years after getting implants, it’s extra hard to get a firm diagnosis 5.

If you have breast implants and start to notice symptoms, it’s a good idea to keep a detailed symptom journal that you can share with an integrative or functional healthcare provider. 

Regular doctors can be helpful, too, but they may not be trained to look for the root causes of your symptoms. Since BII isn’t an official medical diagnosis, it can be hard to get clear answers or proper treatment through the standard medical system.

A holistic provider is likely to run tests to rule out other conditions that have similar symptoms to BII, such as autoimmune diseases, Lyme disease, and other vector-borne illnesses, thyroid disorders, or heavy metal toxicity 10. They may also order imaging tests like an MRI or ultrasound to look for hardened scar tissue or a silent implant rupture if your symptoms point that way 10.

How to Manage Breast Implant Illness

Dealing with possible breast implant illness can seem overwhelming, especially if you can’t get your implants removed. But there’s still hope. Holistic treatments may help you feel better, even if removal isn’t an option.  

Breast implant illness is likely linked to inflammation, and there are many ways to help reduce inflammation in the body. A major one, and our focus at the clinic, is to correct any gut issues that may be fueling body-wide inflammation. 

Eating a nutritious diet and building healthy lifestyle habits are powerful ways to improve your gut health. A healthy gut can lower inflammation in the body, support the natural detox process, and improve how you feel overall. So, this is a great place to start if you’re having symptoms consistent with breast implant illness.

For clients with symptoms that seem to stem from inflammation, we recommend a whole-foods meal plan like a Paleo diet. It can help lower inflammation and balance blood sugar—both of which could have a positive impact on BII symptoms 13 14.

Along with healthy dietary changes, we suggest the following lifestyle strategies, which support the entire body and calm inflammation:

• Getting healthy sun exposure
• Walking and other exercises
• Optimizing sleep
• Managing stress  
• Avoiding toxins

In short, consistently supporting your gut by eating well and leading a balanced lifestyle could help you feel well again and even avoid having to consider getting your implants removed. 

If not, it’s time to look into other possible root causes of your symptoms—like inflammation from allergies, toxins, infections, or stress. This is where integrative and functional medicine providers shine. 

What About BIA-ALCL?

In addition to breast implant illness, a type of cancer called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) has been identified. BIA-ALCL is not breast cancer—it’s a rare type of immune system cancer called non-Hodgkin’s lymphoma that can form in the scar tissue around breast implants 4 15. 

The risk of BIA-ALCL is considered low, but it can occur in anyone with breast implants, whether they’re filled with salt water or silicone. In any case, the risk seems to be higher in people with textured implants 3 15. 

The symptoms of BIA-ALCL can include 15: 

• Ongoing swelling around the breast
• Pain near the implant 
• Fluid buildup around the implant (called seroma) 
• A lump you can feel under the skin 
• Hardening or tightening of scar tissue around the implant (known as capsular contracture) 

If you have any of these symptoms, I urge you to tell your doctor right away. BIA-ALCL is usually treated by removing the implants (aka explant surgery), but some people also need chemotherapy or radiation 15. 

Should You Remove Your Breast Implants?

Having your breast implants removed is a personal decision. 

General recommendations are to have breast implants replaced every (or removed after) 10–15 years. If you don’t have any of the following, you probably don’t need to replace or remove them sooner 16: 

• Hardening of the tissue around the implant (capsular contracture) 
• Symptoms of breast implant illness (listed above)
• Implant breakage or leaking
• Pain related to the implant 
• Implant shifting out of place 
• Calcium deposits forming around the implant 
• Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)

The following table provides some potential pros and cons of having your breast implants removed (explant surgery) 16: 

Breast removal surgery requires general anesthesia and is usually performed in an outpatient setting 16. It may be necessary to have an MRI or ultrasound before surgery to check for implant ruptures or BIA-ALCL 11.  

Breast implant removal surgery involves removing the implants along with the layer of scar tissue (or capsule) around the implants. There are two options for this surgery 11: 

• Total capsulectomy where the breast implant is removed first and then the capsule is removed in pieces 
• En bloc capsulectomy where the breast implant and capsule are removed as one piece 

Your plastic surgeon can help you decide which type of surgery is best. After surgery, the capsule may be sent for testing to rule out cancer and to look for bacteria and fungus. 

Recovering from breast explant surgery can take 2–6 weeks or longer. It’s important to follow your surgeon’s specific recommendations for 16: 

• Which type of bra to wear
• How to care for your incisions
• The type and amount of physical activity that is safe
• Which medications to take
• When to follow up

Expect to avoid many of your typical daily activities, including driving, strenuous activity, and lifting heavy objects for 1–2 weeks. And you may feel sore and tender for up to 6 weeks. 

When to Consult With A Health Practitioner

If you have breast implants and begin to notice many symptoms such as joint pain, brain fog, and muscle aches, it’s important to meet with a healthcare provider to determine the root cause(s) of your symptoms. 

While you’re working to develop a comprehensive treatment plan, supporting your gut and overall well-being with an anti-inflammatory diet and lifestyle changes may help you feel better. 

If you have breast implant illness and want to learn more about optimizing health, we’d be honored to partner with you on your healing journey—contact us at the Ruscio Institute for Functional Health for an appointment.

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