Breast implant illness is the term patients use for a group of systemic symptoms — fatigue, brain fog, joint and muscle pain, rashes, hair loss and others — that they attribute to their breast implants. It is not a formal diagnosis, there is no blood test, scan or biopsy that confirms it, and the cause is not established.
None of that makes the symptoms imaginary. Women reporting them are unwell, and the absence of a test is a gap in medical knowledge rather than evidence that nothing is happening.
Where things actually stand
| Question | The position |
|---|---|
| Is there a diagnostic test? | No. No biomarker, imaging finding or pathology result confirms it |
| Is a cause established? | No. Proposed mechanisms exist; none is proven |
| Is it recognised by regulators? | The TGA discusses it on its consumer breast implant hub |
| Do symptoms improve after removal? | Many patients report improvement. The published studies are largely observational and without control groups, so the size of the effect is uncertain |
| Is it the same as BIA-ALCL? | No. BIA-ALCL is a defined cancer with a defined test |
The step that gets skipped
Before attributing symptoms to implants, the conditions that produce the same picture need excluding — thyroid disease, iron or vitamin B12 deficiency, autoimmune conditions, sleep disorders, perimenopause, depression and anxiety among them. Several are common, and several are treatable.
This work belongs with your GP, and Dr Kumar will ask whether it has been done. It is not a way of dismissing you. If something else is causing your symptoms, removing your implants will not fix it, and you will have had an operation for nothing.
What Medicare does and does not cover
This is the part most often misunderstood, and it is worth knowing before you plan.
Item 45551 — removal of a breast prosthesis with excision of at least half the fibrous capsule, not with insertion of any prosthesis — is intended for specific indications: capsular contracture, a mass within the capsule, or evidence of BIA-ALCL or other malignancy. Where it is claimed, the capsule must be sent for histopathology.
Item 45548 covers removal of a breast prosthesis as an independent procedure.
The practical consequence: symptoms attributed to implants, on their own, do not meet the indications set out for 45551. Which item — if any — applies to you is determined by what is actually found clinically, and your quote will set it out., and cover the surgeon’s fee only.
If you want your implants removed
You do not have to prove a diagnosis to have your implants out. It is your body and it is a legitimate choice. What Dr Kumar will do is make sure you go into it with accurate expectations:
- Other causes should be investigated first, with your GP
- Symptom improvement is reported by many patients but cannot be promised
- The breast will look different afterwards — often smaller and lower than before implants, because the tissue has been stretched
- Whether a lift at the same time is sensible, or better delayed, is decided on examination
- The capsule is dealt with according to what is found, not according to a fixed policy
Explant surgery sets out the operation itself, and en bloc capsulectomy deals with the term you may have read about online.
Common questions
Are certain implants more associated with it? Reports involve both silicone and saline, smooth and textured devices. There is no established pattern that lets you predict it.
Should I have my implants removed as a precaution? Australian regulators do not advise removing implants in women without symptoms.
Can testing the capsule tell me anything? Histopathology looks for specific disease, including lymphoma. There is no pathology finding that confirms implant illness.
Will my GP take this seriously? Most will. Going in with a written list of symptoms and their timing helps.
Do I need to decide now? No. There is no urgency in the absence of a mass, swelling or pain.
Next step
Bring a GP referral — it is required to see Dr Kumar — along with your implant cards and any investigations already done. You will get a straight answer about what surgery can and cannot be expected to do for you. Call 1300 267 726. More about implant removal and revision.
The initial consultation with Dr Kumar is $400, with a Medicare rebate of approximately $88 where you have a GP referral. Surgical fees are quoted individually after your consultation, in a written itemised quote.
All surgery carries risks, and individual results will vary. Read more about the risks of surgery here. A GP referral is required to see Dr Kumar.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
