 Hi everyone, Dr. Saul here in Beverly Hills. Today I'm going to give you a little review on breast implant illness. Breast implant illness is something new, but a lot of more people have been looking into it and there's more research paper about it. I reviewed two studies that were published. Breast implant illness is that some people have reaction to their breast implants. It's not everyone. It's a very small minority, but still we have to give it recognition and help out those people that need it by taking out the implants. Let's take a look. So breast implant remains poorly defined and controversial complication. There was something similar in the 1960s. They called it human abdrunk disease, but now they've changed it to breast implant illness. It's a constellation of symptoms and it's not just one organ. It could be different organs. It could be the muscles. It could be bones. It could be joint. It could be even some people have some fogginess. So it's different symptoms. We'll review that. The rate of incidence, we're not sure because it's something that's being currently studied. One study I looked at, they look at nine different symptoms. Fatigue, arthritis, which means joint pain, myalgia, muscle pain, cognitive impairment. That's fogginess, dry eyes or mouth, alopecia, which is hair loss, skin lesions, or renal syndrome, which is an autoimmune disease. So the pathophysiology behind it, it's an autoimmune or inflammatory reaction to the stimulating agent, which is silicone. Just a reminder to everyone that all breast implant shells are made out of silicone. Not just silicone implants, but even saline implants, the shell of it contains silicone, although it's not liquid, but there is silicone in that. The first study I did, it showed that after removal of the breast implant and associated capsule, it significantly reduced their symptoms. So that's very important. We need further investigation. That was the first study was that there should be further investigation into these symptoms and see what we get out. The second study I looked at, there was 50 patients in there and 84% of the patients have improvement, partial or complete resolution of their symptoms. So what they did in the second study was the patient came in with symptoms, they did perioperative questionnaire, they took out the implant and the capsule, they did some microbiology studies on some and histopathology on some, then they had a questionnaire and they did symptom analysis. In this second study, they did some other 11 symptoms, numbing and tingling, joint and muscle pain, hair loss, memory loss. You could see most of them are the same thing, dry eyes, chronic fatigue, breast, rashes, food intolerance, flu-like symptoms, and even in difficulty breathing. The most common ones, you could see were fatigue and arthralgia, which is joint pain and brain fog. Those are very common and then there's the list of the others which we've gone over and autoimmune diagnosis also. Again, in this study, they did both saline and silicone and there was no difference with either one because both are made out of silicone shell. And this is why it would explain that both saline and silicone implants led to improvement after removal of the instigating factor. So one possible mechanism which was looked at was the capsular contracture. People that have capsular contracture have inflammatory reaction to the silicone. So you could see they had, those had more significant pains as breast pain, muscle and ache pains and even difficulty breathing related to chest wall restricted movement. Because when you have a capsule, the capsule can calcify and it's going around the implant and really tightens around the implant as the calcium gets thicker. As I spoke to you, as I talked before, it's a secondary reaction to inflammatory reaction. So that's what they believe it's inflammatory reaction. And another thing that they found out in the second study was because obesity is considered a pro-inflammatory state, they thought that the people, the obese people have even a more symptoms but they got better improvement when the implant was performed, implantation of the implant was performed. So all 11 symptoms were improved or relieved after the implant and capsule were removed. In the second study, the symptoms were not correlated to implant type. Again, it doesn't matter if it's saline or silicone, what kind of surface they have if they were textured or smooth or what the product inside was. And there was significant, there was no significant finding as how long the implant was in or if the plant was above or underneath the muscle. And what was persistent in 36% of the cases that they found a common bacteria in there that was cause of chronic infection. These are other symptoms that have been expressed through breast implant illness. You could see it's a very long list. I'm not going to go over all of it for you. I'm going to show you a case where we had a patient that had capsular contracture, had the implants in for a while. She was 31. She was tired of them. So we took them out for her. We did a wise patterned breast lift or otherwise known as an anchor. She wanted to go back to her natural state and she had improvement of her symptoms. You could see they looked very natural, very beautiful. She healed this in only two months out. So you could still see a little redness, but she went back to her natural state and she was very happy with it. And you could see that capsules are removed posterior, anterior, and the implants.