What is the cause of Breast Implant Illness (BII)?

Written by Board Certified Plastic Surgeon Nima Naghshineh, MD, FACS on July 8th, 2020.

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There are several individual theories about what causes BII, some hinge on the idea that there is some degree of interaction between the implant, a pro-inflammatory presence (typically bacteria or fungus), and the body’s exaggerated response to all of this. It has been shown that a large percentage of capsules (>40%) removed at time of explantation had bacterial colonization1.

There are different kinds of inflammatory response your body can create, as outlined in this drawing from a medical journal. Inflammation can lead to scarring which is a typical response after surgery but when exaggerated can lead to hardening and thickening and contraction of that scar or capsule your body forms around the implant. This then leads to a well-known condition called capsular contracture which can cause breast shape deformity and pain. Another form of inflammation many are aware of is an allergic reaction. Allergies form through inappropriate or undesired immune system response to an antigen (something foreign like pollen or metals). Additional forms of immune system malfunction can lead to one’s own immune system attacking the body. This is a general simplified idea of how autoimmune diseases occur. And when normal immune cells mutate or grow out of control that leads to cancers like lymphoma.