by Kim Smolders, FMCHC
MY EXPERIENCE WITH
BREAST IMPLANT ILLNESS
An emotional and physical journey that has taught me everything about
my body, health, self-worth & the powerful beauty of womanhood
BREAST IMPLANT ILLNESS
THE DARKER SIDE OF BREAST IMPLANTS NO ONE LIKES TO TALK ABOUT
With collective female self-esteem, identity and self-confidence at an all-time low, plastic surgery is at an all-time high. We only need to open a magazine or scroll through Instagram and we are met with images of women with unnatural, unreal and photoshopped bodies. It has become the norm in a society that is obsessed with the physical and ‘perfection’, planting seeds of doubt in girls and women of all ages and backgrounds. This, accompanied with the still persistent objectification of women, has sadly ensured that the waiting rooms of plastic surgeons all over the world are consistently filled with insecure women, convinced that a surgical procedure will cure their unhappiness.
According to the International Society of Aesthetic Plastic Surgery (www.isaps.org) 11 million plastic surgeries took place globally in 2019, 30% of which were to the breast. That means there are more than 9000 breast augmentations, reconstructions, lifts and reductions being done a day.
Getting Implants
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Like most women that look to plastic surgery, I was self-conscious about my body. I have a very slim build, androgynous and model-like, so female curves have always eluded me. I first considered breast implants after a woman with the ‘perfect’ body in a silky red dress caught the eye of my then boyfriend. He could not take his eyes off her all evening (he could in fact not take his eyes, nor keep his hands, off a lot of women). I was clearly in a psychologically abusive relationship where cognitive dissonance was constantly present and emotional stability and safety were lacking. I was also spending a lot of time in Monaco, where surgical enhancements to the body are as frequent as trips to one’s therapist - often! Believing that ‘perfecting’ my body would make me more valuable, loveable and self-confident, I too decided to make a trip to a plastic surgeon
My first encounter with a plastic surgeon was a rather wonderful one; unlike any other doctor’s consultation you will go to. They know how to say just the right things by feasting off your insecurities and desire for beauty, making you want to have had the surgery yesterday. The surgeon I visited reassured me that a breast augmentation is a simple procedure, even though he would tear my muscles from my ribcage in order to place the implant underneath to give me a more ‘natural’ look. He also mentioned that I would be able to go out for dinner the day after and that due to modern advancements the current implants have a lifelong guarantee. Apparently, they are the safest they have ever been with risk of tearing or leaking being almost impossible. To emphasise this point he added that most of his patients went at least ten to twenty years without issues or replacement. His laissez-faire demeanour made me feel very at ease and took away any worries I had about having such invasive surgery. Little did I know then however, that all this could not have been further from the truth.
"Women predominantly have breast implants placed to fill an internal need or lack. Sadly, external fixes will not solve internal or emotional problems."
Health Problems​
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In the five years that I had my implants I had to have four different corrective surgeries, all under general anaesthesia. I also felt and saw my health decline physically and psychologically. I couldn’t quite put my finger on it, but I just wasn’t myself anymore. This daily feeling of all-over inflammation, serious brain fog, lack of energy, heavy eyes, fatigue, terrible insomnia, mood swings, not being able to breathe deeply and thinning hair made me desperate to look for answers.
I had all sorts of blood and other tests done, but nothing out of the ordinary was found. And yet, I knew my body and I felt that something was just not right. I live a pretty healthy and holistic lifestyle and have done for many years - I follow a pescatarian diet, do not eat sugar, drink the daily recommended amount of water, exercise plenty, try to do time restricted fasting a couple of days a week and do cryotherapy and infrared sauna (which I now know can in fact be destructive to health if used with implants still inside the body). Looking back, I think that this healthy lifestyle actually kept me from falling victim to more serious illness. At the time, doctors thought it could be stress from my abusive relationship or even aging at the tender age of 35. With no concrete answers being given as to why I was struggling and feeling far from optimal, I decided to do some research myself. This led me on a journey not only of healing and self-discovery, but one of hope and empowerment.
Breast Implant Illness
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I first came across the term Breast Implant Illness (BII) when I joined a Facebook group dedicated to this topic, which had 138.000 women members at the time. In the five months that I have been part of it, it has grown to 147.000 members. Joining this page of incredibly wonderful, courageous women was my aha!-moment. Women shared their heart-breaking stories of physical and psychological pain and lifechanging symptoms, some of which I myself experienced, but many which were terrifyingly worse. Autoimmune diseases such as IBD, ASIA syndrome, Lupus, Lyme, Hashimoto’s and rheumatoid arthritis to name a few are common, as is cancer, in particular lymphoma and BIA-ALCL, cancer of the immune system that was officially recognised by the FDA in the US in 2017 to be linked to textured breast implants. Others shared their inexplicable battles with cardiovascular problems, joint pain, allergies, gut and hormonal imbalances, skin problems, hair loss, mood fluctuations, depression, lack of energy and chronic fatigue. Some women’s bodies have been so impacted that they are in and out of hospital or bed-bound with unexplained symptoms, unable to work or care for their families.
"Breast Implant Illness: a variety of symptoms experienced by women after having breast augmentation and/or reconstruction surgery."
Many women, desperate for answers, go through many medical tests and diagnostic procedures that are often expensive, invasive and time-consuming. More often than not, these tests are inconclusive or are not able to identify the cause of their symptoms. Even more worrying is that the link between breast implants and these symptoms is rarely, if ever, made. As humans, and I dare say even more so as women, we know our bodies intimately well. This primes many women to do more research for themselves, leading them to the heartbreaking discovery of BII, just as I had done.
Never in the five years that I had breast implants did I hear the words Breast Implant Illness. Not from my plastic surgeons, not from doctors or specialists, from no one. And yet I refuse to believe that they are not aware of the term, nor the destructive impact that breast implants can have on one’s body. They just don’t want it to be said or known.
Toxic Silicone All Over The Body
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The fact that there are heavy, foreign objects in your body, sometimes weighing more than 1kg and sitting on top of your most vital organs (your heart and lungs) is already legitimate reason for concern. And then we have not even touched upon the damaging effects that the toxic chemicals and silicone contents of the implants have on your immune system and body.
I never looked into what breast implants are made of until I researched BII. My plastic surgeon never mentioned it and, stupidly, I never asked. On one of my explant consultations I was told breast implants contain over thirty toxic substances, including heavy metals and silicone, the latter being the one that is most talked about. But all implant contents are highly toxic and damaging to the body. Even saline implants, generally considered safer than silicone implants as they are filled with salt water, have a silicone shell and can still wreak havoc on the body. Rather than informing patients of what the implant are made of, and the potential dangers associated with this, plastic surgeons will rather tell you that the implants they place are safe, as did mine, and that there is very little chance in tearing and what is known as ‘gel bleed’. Gel bleed is the constant release of microscopic droplets of the implant contents into the body. Whilst many plastic surgeons maintain that implants do not gel bleed; new studies have found that they in fact do and in time, silicone, metals and other substances can be found in the tissues surrounding the implant, as well as your cells, lymph nodes, hair, muscles and other tissues all around the body. An implant need not be old or ruptured for the toxins to spread; even whole implants that have only be placed for a short amount of time can poison you and make you gravely ill. Generally, however, the longer you have them, the more chance you have of experiencing symptoms and getting ill. A study from 2020 concluded the following: “The results suggest that the release of silicones from implants by gel bleed or implant rupture leading to the generation of tiny droplets that migrate through the body may affect health by triggering cell death in certain organs and tissues.”*
Foreign Objects Inside Your Body
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Sadly it is not just the silicone and all the other toxic substances the implants are made of that cause serious health problems. An implant will always be an unnatural, foreign object in your body, and your immune system will recognise it as such. From the moment the implant is placed, your immune system is activated. It wants to ‘protect’ your body from this intruder by forming a capsule, made from your own scar tissue, around the implant. As this capsule gets contaminated with the chemicals from the touching implant (besides silicone and heavy metals, even bacteria and mould have been found in explanted capsules), your body will never see this tissue as its own, leading to a continuously heightened immune system. The porous nature of this capsule does not contain the aforementioned microscopic toxic particles that are released via gel bleed and can thus spread all over the body causing more damage. Over time these capsules are likely to become calcified, causing the breast to become harder and misshapen, an unwanted side effect that happens far more frequently than we realise.
All this physical stress means the immune system is fighting continuously. 24/7. This takes a lot of energy, energy that is otherwise directed at healing, keeping your organs working optimally and keeping you generally healthy. The implants are the trigger that pushes the body into a highly inflamed state and an imbalanced immune system which we now know lead to all sorts of chronic health problems and auto-immune diseases. In other words, it leads to Breast Implant Illness.
Explanting, removal of the implants and the surrounding capsules, is highly recommended so that your body can reset and start to heal itself. As the capsule is also toxic, it is essential that it is removed to ensure optimal healing. Our bodies will always find a way to maintain what is know as homeostasis (balance), so once the source of toxicity I removed, it will work at healing itself provided it is nourished physically and psychologically with pure, natural, whole foods and strong, loving, positive thoughts.
"From the moment the implants are placed, the body is fighting them 24/7. This, along with toxic silicone particles from are released via gel bleed, causes chronic stress & inflammation in the body."
BII Acknowledgement In The Medical World
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Plastic surgeons, specialists and doctors around the world are still convinced that implants and silicone are not damaging to the body, and that they cannot be the cause of the many debilitating symptoms that hundreds of thousands of women with implants are experiencing. On the contrary – they keep telling us full of conviction that they are safe. Fortunately, more and more studies are being conducted into the possible link of breast implants to BIA-ALCL as well as auto-immune diseases, and the FDA only very recently updated their recommendation with regards to breast implants: there should be a boxed health warning, patients need to be presented with a decision checklist, materials and chemicals found in/released by implants need to be clearly communicated and there needs to be a recommendation for regular rupture screenings. The fact that the FDA has, after 60 long years, decided to make these recommendations is profound. Whether plastic surgeons and manufacturers actually follow them is another matter as FDA recommendations are not in fact legally binding. I fear that unless they become so, it is a weak attempt at vital knowledge awareness that will fail.
Increasingly however BII is garnering scientific interest and there are numerous studies ongoing (some independent) to clarify the link between BII and the symptoms that are being reported so frequently. In the USA, more so than anywhere else in the world, there are now ‘explant surgeons’ that are dedicating their time and expertise solely to the removal of breast implants and advocacy of BII. The painful stories of the deteriorating health of so many women, 90% of whom get better in the days, weeks and months post explant, can simply no longer be ignored.
"The majority of plastic surgeons around the world still maintain that breast implants are safe and sadly refuse to accept the existence and severity of Breast Implant Illness."
Of course, one cannot attribute all symptoms and illnesses to breast implants, and as a health coach, I am well aware of that. Factors such as diet, stress, sleep, movement and lifestyle choices all play their part in one’s physical and mental health. However, it is strikingly remarkable that so many women describe many of the same discomforts, symptoms and diseases after getting implants, only to see these subside after they have explanted.
This then raises the questions: why can it be that when so many women worldwide experience adverse health effects after getting breast implants the medical world has still not made the link between the two? Why is the existence of BII denied by so many, medical professionals alike? How many more women are there with symptoms who do not realise, or refuse to believe, that their implants are making them ill?
Plastic Surgeon’s Reactions To Explanting
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I had two sets of implants over the course of five years, placed by two different surgeons, and neither of them made me aware of any possible serious health implications, let alone mentioned BII. All the information I received was positive and caused no reason to worry. Only very recently, when my research into BII began, did I come to realise that my first set of implants, placed in 2016, were Allergen Natrelle. These were globally recalled by Allergan in 2019 due to the link between BIA-ALCL and textured breast implants. The surgeon who placed them never got in touch with me to tell me about this recall. What is even more worrying is that my second set were also textured implants, albeit from a different manufacturer. When I went back to my two plastic surgeons with this information I had collected about BII and BIA-ALCL, they were both dismissive and suggested that, and I quote, “I spend less time reading sensationally fabricated and untrustworthy stories online”. I was shocked. Whilst plastic surgeons, I am convinced, are well aware of the possible health complications, they are still not sharing these crucial pieces of information with many patients who are clearly not. It is of course blatantly obvious why they don’t – it would ruin their billion-dollar business and reputations. This information would make many women think twice about having these toxic objects placed inside of their bodies.
It is clear that a more truthful and balanced picture of breast augmentation needs to be given at the initial consultations. Whilst women should always do their own research when pursuing surgical interventions, there has to be a duty of care on behalf of the surgeons to rightfully inform us; it is professionally irresponsible and potentially life-changing and dangerous if they do not.
My own journey from implant to explant has been more transformational than I could ever hope for.
The Explant Disrespect
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I found out about BII in early February of 2021, and I explanted on March 9th, just a few weeks later. I visited no less than four different surgeons, including the one who had placed my second set. It turns out explants are rarely performed, so finding the right surgeon was quite the mission impossible. All the plastic surgeons I visited had only done a handful of explants in their long, lustrous careers, and I am sure the term a handful was terribly exaggerated. Don’t get me wrong, they are all top-notch plastic surgeons with years of experience and invaluable expertise, but explanting is not something they are familiar with, or like to do. This worried me slightly as an explant is a much more complicated surgery than a breast augmentation – the capsule is often times stuck to the surrounding muscles, tissues and ribs, and requires real skill and patience to be removed fully and safely.
When I uttered the words explant and BII, most of the surgeons I visited looked at me with disgust and disbelief. When you go in to see them for a breast augmentation, they love you, but when you wish to discuss an explant, not so much. It was very telling that in my moments of courage and vulnerability, they were disrespectful, derogatory and dismissive. They had the nerve to berate and invalidate BII, deny any link between my symptoms and my breast implants, and remind me of how safe the silicone implants in fact are. My original plastic surgeon even went so far as to tell me that post explant I would “have teabags” and would be “in need of a psychiatrist a I cried rivers”. He was also sure I would be back within a few weeks, desperately begging him for a new set of implants. This utter rejection and humiliation by a medical professional, my own surgeon no less with whom I had built a relationship of trust, at a time when I was being open and vulnerable was shocking to say the least. He owed me a professional and worthy answer; that is his duty in his field of practice.
"Whilst women should always do their own research when pursuing surgical interventions, there has to be a duty of care on behalf of the surgeons to inform us fully, honestly & with respect."
The past five months I have read countless stories of women looking to explant experiencing the same lack of understanding and humiliation at the hands of plastic surgeons and specialists, as if the journey of explanting is not already difficult enough for us, both physically and emotionally. We deserve the respect to be heard and to ask questions that will inform our decisions about our own bodies based on correct, unbiased and objective information.
Hope & The Need For Change
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BII is clearly still taboo in the world of plastic surgery despite increasing evidence of its existence. Breast augmentations continue to be big business and anything challenging this will be unpopular and met with resistance. But slowly the truth is coming out. Women are sharing their stories and experiences in increasing numbers, and this can no longer be ignored. The number of breast augmentations performed annually is slowly decreasing, and the number of explants increasing. There is hope, even if it is still difficult to find a skilled explant plastic surgeon who truly hears you, who believes in BII and who will work with you to get you back to optimal health.
I was fortunate enough to find one in Antwerp - Dr van Look. Explanting was not a procedure he performed regularly when I went to visit him in early 2021, but he is a BII-believer and has performed many explants since I had mine. He recognised my symptoms and was keen to help relieve them whilst also making sure I went back to beautifully being my small-breasted self. I often feel that I have wasted years, lost friendships and sacrificed careers because I lost myself, both mentally and physically, due to my implants.
"Explanting takes a lot of soul-searching, time & courage. Not only does it address the profound matter of one's health, it also touches deeply on the subject of femininity & body image."
Women need to be given the right information so that we can make informed decisions about what we put in our bodies, and breast Implant Illness should be an important part of the conversations around breast augmentations. There will always be women who will struggle with this knowledge, who may even be in denial about it. I have come across them myself. Explanting takes some soul-searching, time and a lot of courage. Not only does it address the critical matter of health, but the crucial, yet fragile topic of body-image. This is the reason I feel that this battle is one that belongs in the medical realm, but maybe even more so in the wider context of body positivity and femininity. A context that is still in need of so much change - women are still confronted daily with unrealistic ideals of body image that are not natural and that can never be achieved without surgical interventions, and despite some emancipation and progress the last few years, the struggle of equality and recognition, and the battle against objectification and the suppression of women is sadly also still an ongoing one.
The Beauty & Power Of Women
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Yet there is such beauty in the fact that so many women worldwide are in increasing numbers finding their strength and taking their health and bodies into their own hands by opting for an explant in spite of the difficult emotional and physical journey that accompanies it. This proves that we believe in the best, most natural versions of ourselves, and that we will no longer accept these unrealistic standards that are forced upon us. But what I find most magical is that as women we are strongest and most powerful when we come together and share our stories, experiences and wisdom to support each other, inspire change and make the world a more wonderful place.
I am grateful that my experience with BII has been relatively mild in comparison to many other women, but we are all ‘breasties’, now part a community of women with a common knowledge and similar stories of survival. We are all passionate about raising awareness and bringing about change not only in the medical world, but in broader society in relation to body image, health and mental health.
The silver lining to my implant-to-explant journey has been that I have found my passion - Functional Medicine Health Coaching. I am passionate about raising awareness around the topic of BII and optimal health, helping women not only through the explant journey and thriving after healing, but through all sorts of health challenges we face today.
Authenticity & Finding Myself Again
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Authenticity was my word of 2021 and wow did I live up to it! I am still healing after my own explant in March, and #thehealisreal! After five years of implants, I am finally me again. I have never felt more real, authentic and alive. This unexpected journey has forced me to look deep inside myself, address issues I had been ignoring for too long and take charge of my life. It was my rebirth. And whilst it has not always been easy, I do not for a second regret my decision. If anything, I wish I had done it sooner. It is truly remarkable how my body has quite literally been reborn now that it is implant free. The inflammation that was plaguing and ruining my mind and body has melted away. I am sleeping again. I have energy and a lust for life. I have slimmed down and toned up, my hair, skin and eyes are radiant again. I have become lighter in every sense of the word. I will be healing over the next two years as breast implants throw your body so off balance that it takes months and great efforts to find homeostasis again, but I already notice great improvements every single day that I celebrate happily. I am falling in love with myself and my own body again, appreciative of my small and beautiful breasts that I have so missed.
And that is femininity at its best – authentic, natural and strong!
"There is such beauty in the power of women coming together and sharing their stories, reclaiming their health & bodies and believing in the natural, best versions of themselves."
* Onnekink, C., Kappel, R.M., Boelens, W.C. et al. Low molecular weight silicones induce cell death in cultured cells. Sci Rep 10, 9558 (2020). https://doi.org/10.1038/s41598-020-66666-7