What Are the True Rates of Breast Implant Illness?

Someone asked me a completely fair question: what are the actual rates of breast implant illness after a breast augmentation?

Here's the honest answer, and I know it's unsatisfying: we have absolutely no idea what the true rate is. Not because nobody's looked, but because of specific, fixable problems with how the question has been studied. Let me explain what those are.

This is the biggest obstacle. Breast implant illness is very difficult to pin down as a diagnosis, because there have been over 150 different symptoms associated with implants.

A condition with 150 possible symptoms isn't really a defined illness, it's a very wide net. And you cannot calculate a rate for something you can't consistently define. If two researchers can't agree on who counts as a case, they can't agree on how many cases there are.

To genuinely determine the percentage of patients who develop symptoms, we need three things:

Most of the work done so far has been retrospective, meaning we look backwards at patients who already have implants. Retrospective data is inherently weaker. What we need is a prospective study, designed up front, following patients forward in time. (This is the same evidence-quality problem I walked through when a bad BII meta-analysis started circulating.)

We need an actual diagnostic definition that doesn't sprawl across 150 symptoms. That's not helpful to anyone, patients included.

This is the piece people most often skip. Whatever symptoms we decide define the illness, we have to compare them against women who don't have implants. Otherwise you have no idea whether you're measuring an implant effect or simply the background rate of being a human being.

And here's what happened when researchers did that:

That doesn't close the question, it's retrospective work with all the limitations above. But it's a meaningful signal, and it's why I'm cautious about the confident percentages you see quoted online.

There have been talks of an ongoing study in the plastic surgery community looking at exactly this question, and it's been discussed for quite some time. But I have heard no rumblings about where it stands. Hopefully we'll have a better answer in the future. Right now, we don't.

I want to offer my clinical experience for whatever it's worth, with the caveat that one surgeon's practice is not data.

Most plastic surgeons who do a lot of implant surgery, myself included, across both cosmetic and reconstructive patients, don't commonly see patients develop breast implant illness.

And I want to be clear that I'm not dismissing these patients. I take care of them all the time. They come to me and I help restore them after implant removal. But among the implant patients I place and follow, this isn't a large issue in my practice.

I completely understand not wanting a foreign body in your body. And I completely understand being worried about breast implant illness. Those are reasonable feelings and I'm not going to talk anyone out of them.

But the best move is to go in and talk to a plastic surgeon rather than making the decision from what you read online.

Here's why that matters practically: the most important thing is that you get the outcome you want. And the reality is that fat grafting augmentation and implant augmentation produce different aesthetic outcomes. They just do.

So you want to get what you personally want, and you don't want to settle for a surgery whose outcome will be suboptimal for you out of fear of something whose rate nobody can actually quantify. That's a decision worth making with an expert in the room.

• We do not know the true rate of breast implant illness, and anyone quoting you a confident number is going beyond the evidence.
• The core problem is that over 150 symptoms have been attributed to it, so it isn't a definable diagnosis you can calculate a rate for.
• We would need a prospective study, a defined set of criteria, and a comparison group without implants.
• Retrospective comparisons of women with and without implants have not shown a difference in the most common attributed symptoms.
• In the practices of surgeons who do high implant volume, it is not commonly seen, though clinical experience is not a substitute for data.

Information online can be really scary, and it often makes rare things feel common. You deserve accurate, evidence-based information when you're making a decision about your own body, including an honest "we don't know" when that's the truth.