[The Janus face of breast implant diseases I.]

The modern development of plastic surgery has significantly contributed to the positive change in body image and self-esteem. For the past few decades, the use of plastic surgical implants has been a fundamental tool in reconstructive and aesthetic surgery. At the same time, over the past two decades, in addition to scientific medical literature, the following implant-related conditions have gained increasing attention in public discourse, the press, and tabloid media: breast implant illness (BII), breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), and breast implant-associated squamous cell carcinoma (BIA-SCC). So, these clinical entities not only cause medical problems, but they also cause psychological, ethical, and social problems. Breast implant illness is a heterogeneous syndrome in which patients report various systemic complaints (such as chronic fatigue, joint and muscle pain, mood disorders, hair loss, etc.) to their breast implants, without any clear correlation being demonstrable or any objectively detectable clinical parameters being present. In cases of breast implant illness symptoms, based on appropriate diagnostic and differential diagnostic findings and indications, currently one of the primary and most important treatment strategies is the removal of the implant and surrounding connective tissue (explantation + total capsulectomy). 60-80% of patients report that their symptoms have been partially or completely resolved following surgery. This review article presents the immunological and pathological processes associated with breast implant illness, as well as its epidemiological and clinical aspects, offers recommendations for modernizing surgical practice and communication strategies in light of the international literature and guidelines. Orv Hetil. 2026; 167(40): 1593-1604.