Defining Breast Implant Illness: A Systematic Review and Meta-analysis of Patient-reported Symptoms

Although no definitive scientific link has been established, public concern surrounding breast implant illness (BII) is increasing. To study this potential condition, a clear definition is necessary. This systematic review aimed to characterize BII through a meta-analysis of patient-reported symptoms.

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive literature search was conducted. The relative risk (RR) of the top 10 symptoms was meta-analyzed, comparing patients with and without breast implants. Additional analyses assessed whether surgical or patient-related factors influenced symptom occurrence.

A total of 36 articles were included in this study, accounting for 10,519 patients. Fatigue or malaise (RR = 3.15 [2.89-3.43]), myalgia or weakness (RR = 2.96 [2.76-3.18]), and cognitive dysfunction (RR = 2.87 [2.64-3.12]) were most strongly associated with the presence of breast implants. Implants that were ruptured (RR = 1.12 [1.04-1.21], P = 0.003) or filled with silicone (RR = 2.11 [1.49-2.99], P < 0.0001) appeared more likely to lead to BII-type symptoms. In contrast, patients who underwent explantation (RR = 0.94 [0.90-0.98], P = 0.003) or had implants for aesthetic reasons (RR = 0.91 [0.84-0.99], P = 0.02) reported fewer symptoms.

Given increasing awareness and concern surrounding BII, it is essential for the plastic surgery community to critically examine patient outcomes. Establishing a consistent, symptom-based definition of BII and identifying key risk factors are necessary to guide future research and improve patient care.