Breast implant illness & explant
Everything you need to understand in one place: what BII is, the science behind it, what the studies show, and how a complete explant gives your body its best chance to recover.
Removing the implant en bloc, together with its capsule as one, gives the body its best chance to recover.
What is breast implant illness?
Breast implant illness, or BII, is a term that came from a group of women who became ill after a breast augmentation. It describes a cluster of symptoms attributed to the implants that varies from one patient to another and affects each woman differently. These symptoms are all connected to autoimmunity, and many of them also appear in recognized autoimmune conditions.
The first thing to be clear about: there are still many unanswered questions about where this condition comes from and how it works. Several theories have been proposed, but there is not yet a clear explanation of why some women develop these symptoms and others never do.
The adjuvant theory
For years, implants were considered safe and biocompatible, even when the body reacted with capsular contracture. But implants may contain an adjuvant, a substance that provokes the immune system.
In some women it sets off a chronic, whole body reaction in which the immune system begins to attack its own tissues. This is not new. The first sign was described more than fifty years ago.
“A small percentage of patients have a predisposition to develop an autoimmune response to implants, what we now call BII.”
Autoimmune syndrome induced by adjuvants
ASIA refers to autoimmune syndromes induced by adjuvants. The origin of many autoimmune syndromes, such as fibromyalgia, Sjögren’s, systemic lupus erythematosus, rheumatoid arthritis, and chronic fatigue, has been classified as idiopathic, the medical word for “we simply don’t know the cause.”
We know that certain autoantibodies and inflammation proteins turn positive, but not why. It is hard not to wonder whether they could be triggered by adjuvants, as happens in some people with silicone implants.
Removing the trigger helps
Every symptom is tied to inflammation somewhere in the body. The idea that removing the trigger helps goes back to research by Dr. Yehuda Shoenfeld, and the data since has been consistent. Large population studies have since linked implants to higher rates of certain immune conditions, and in recent years the U.S. FDA formally acknowledged that some women do experience these whole-body symptoms, an important step after years of women being told it was all in their head.
reported major improvement or full resolution of their symptoms one year after explant.
Dr. Urzola · 504-patient cohort
full symptom remission at 6 months, with 85% reporting improvement.
Dr. Urzola’s ongoing study · 130+ en bloc patients
improved after explant, and 74% reported feeling better with a higher quality of life.
Peters study
of patients improved.
Maastricht cohort study
Removing the whole capsule may matter most: even with an intact implant, silicone can stay behind. Why it affects some women and not others is still unknown.
Results vary from one person to another. These are study data, not a guarantee of outcome.
A few important things to know
The explant
Explant can be performed with or without a lift. Many patients need a lift at the time of explant because of the sagging that appears once the implants are removed. In some cases you may not need one, for example with small implants or good skin elasticity. Your implants are returned to you in a sealed medical bag; pack them in your checked luggage, not your carry-on, for the flight home.
What is an en bloc resection?
When the implant is held inside a capsule the body forms around it, en bloc means removing the implant and that tissue together, as a single piece. It is hard to do, especially separating the capsule from the chest wall when implants sit under the muscle: the capsule tends to adhere to the ribs and the intercostal muscles, close to the lungs. A proper en bloc resection needs a surgeon experienced in the procedure and in chest-wall reconstruction.
Why en bloc matters in breast implant illness
Dr. Urzola believes that many of the adjuvants contained in implants may remain in the biological capsule the body forms around them. Not removing this capsule completely could keep the heightened immune response going. That is why removing everything is the priority, not just the implants.
Total capsulectomy
If an en bloc resection cannot be achieved, a total capsulectomy is performed: the surgeon removes 100% of the capsule in the chest cavity. The capsule can hold bacteria or pieces of silicone that should not stay in your body.
The questions women ask us
Do these sound like you?
These are the symptoms women report most often. They are all connected to autoimmunity, and few doctors take them seriously. Here, you are heard.
- It’s real, not in your head. BII is a recognized cluster of autoimmune-type symptoms. You’re not imagining it.
- It can appear years later. Symptoms often surface long after surgery, and there’s no single blood test that catches it.
- It usually improves. Most women feel better once the implants and capsule are fully removed.
Take this short, private check one gentle question at a time, at your own pace, to see whether your symptoms fit the pattern. It is information, not a diagnosis.
What's your age range?
We never ask for an exact number.
The techniques that restore you
U-Flap, beautiful and natural results
Thanks to this technique, developed by Dr. Urzola, natural results are possible after the implants are removed. It uses a flap of fat tissue from the abdomen to restore the volume and natural shape of the breasts, with no implants. It was developed six years ago and has given good aesthetic results in around 800 women from 28 countries.
Fat transfer, your own natural volume
Restores natural breast volume using your own fat, according to your case. The fat is purified and placed in many small deposits to build soft, even volume that settles over the months that follow.
Breast muscle repair
If the implant was placed under the muscle and the muscle was affected, it is repaired in the same surgery, so nothing is left displaced. Afterward, rest is part of the treatment so the muscle can heal.
Take the first step toward your wellbeing
Tell us about your case and Dr. Urzola’s team will review it personally. No pressure, no obligation.
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