I want to talk about something which is not very topical, but is close to my heart, quite literally as it turns out.
Cast your mind back to 2019, when few of us had ever worn a face mask, traveling to work during rush hour was still the norm, and in our innocence, we had no idea what a precious commodity toilet roll is. I looked pretty different back then, because in late December of 2019 I had breast augmentation surgery, a cosmetic surgery I had wanted for 20 years, and had finally decided to take the… plunge on.
So, in early 2019 – around the time I was shopping around for surgeons and spending a lot of time standing around clinics topless flashing people I’d just met – my partner and I were watching the season finale of Drag Race (the one where Yvie Oddly stole the crown from Brooke Lynne Hytes #robbed), and one of the series judges, Michelle Visage, gave a passionate speech about her journey with Breast Implant Illness, including her decision to remove her own implants, or ‘explant’.
What is Breast Implant Illness, and why did Visage feel the need to use her platform on an international show to… get it off her chest? Breast Implant Illness (or BII for short) is a systemic complication associated with breast implants, where patients experience a wide variety of autoimmune symptoms – some patients and internet groups report huge lists of symptoms, covering everything from fatigue, headaches, hair loss, depression and weight change all the way to liver, kidney, adrenal and thyroid problems. The list of ‘common’ symptoms is well over 50 items long. However despite more than 80,000 people joining Facebook support groups for BII, it is not a recognised diagnosis, and it was this injustice that Visage sought a platform to fight.
Since 2019, Michelle has spoken about her experiences in many interviews and articles, with a feature-length documentary ‘Explant’ in 2021. But to give a brief summary: she had 3 surgeries in total, her first at 21 and her third set of implants in 2016 – of the latter, she has said, “All along, they were making me sicker and sicker, I believe”.
She was also diagnosed with Hashimotos disease (an autoimmune disorder affecting the thyroid) at 29, but struggled to manage her symptoms. In various articles she describes the need to have breast implants as a ”male-dominated toxic way of thinking”, and her implants as the “biggest invaders in my body” that ”needed to come out”. Michelle also talks in detail about the pressures she felt to get breast implants, as a young entertainer in the 90’s in the PlayBoy bunny and Pamela Anderson era, and from boyfriends who would tease her for having a smaller bust.
Honestly my heart goes out to her, and I wish I could be confident that as a society we’d moved past pressuring people into drastic surgery to meet unattainable beauty standards, but social media is filled with Brazilian butt lifts and young people flying to distant countries to get their teeth filed down and replaced with crowns for a perfect smile, so we probably have some way to go.
Surprisingly, she also speaks positively about her implants saying she is “pro plastic surgery and pro women” and that people should do “what you want to do to make yourself feel a certain way [..] But If you choose to go down that path, just have the information.”
Personally I couldn’t agree more. Everyone considering surgery should be fully informed of the risks, and any good surgeon should inform you of cosmetic risks – such as rippling or asymmetry, as well as more serious risks such as capsular contracture and rupture, infection and even BIA-ALCA, a type of non-Hodgkins lymphoma that can develop following breast implants, which led to the recall of certain types of macro textured breast implants and their ban in France.
So, in the interest of being fully informed, let’s take a closer look at the information Michelle cites in her interviews. She advises her audience to check Healingbreastimplantillness.com for further information, the site of a non-profit called the ‘Healing Breast Implant Illness Society of North America’. Their goal is to:
provide wisdom and emotional support through illness, explant, detoxification and uplift women to overcome society’s false concepts of beauty and over-sexualization.
The organisations’ manifesto doesn’t exactly match up with Michelle’s pro-choice stance, and the sugary pastel-coloured site is filled with images that look straight out of a wellness Instagram account.
Unfortunately, it doesn’t take long before the messaging takes a predictable turn from information to psuedoscience. Right on the front page under the heading: ‘Detox Your Body Get Your Glow Back’ readers are told that:
Breast implants are essentially two permeable bags of toxic chemicals and heavy metals implanted in your chest over fragile organs and glands that leak much earlier than you expect. Having breast implants in your body is not going to end well because everyone is affected by the aggressive chemicals and heavy metals that are associated with silicone and are defined as carcinogenic, cytotoxic, neurotoxic, and endocrine disruptors.
This links to further resources for silicone detox, because it’s a snake oil bingo game with a full house. HealingBreastimplantillness.com promotes Keto, Gerson therapy, the Medical Medium, green juicing, antifungal diets, heavy metal toxicity treatment, turmeric and ozone therapy, to name just a few. It is stacked full of people waiting to take money from desperate people with real symptoms looking for anything to help them.
Throughout the site, the messaging is insistent: Explantation surgery is the only option. At no point are the considerable risks described (there is only reassurance that although explantation adds further toxicity to the system, it is the best way and only way to heal BII), and the content repeatedly ignores and belittles the role of breast augmentation for some people in gaining control of their bodily image. Aside from enhancing quality of life through aesthetics, it can be critical for those getting reconstruction following cancer treatments and for women undergoing gender-affirmation surgeries. To brush it off as unnecessary, vain and toxic seems near-sighted at best.
So, what does the science say? The study often cited by BII advocates is a 2018 cohort study of long-term safety outcomes for patients with breast implants, carried out by researchers at The University of Texas MD Anderson Cancer Center. Researchers compared long-term implant-related outcomes and systemic harms for nearly 100,000 patients with silicone and saline implants from two manufacturers (Allergan and Mentor) with normative data from the general population. The results found an increased rate of autoimmune disorders such as Sjogren’s syndrome, scleroderma, and Rheumatoid arthritis in patients with breast implants, but has the limitation that some of the study data is made up of self-reported questionnaires, and the statistical significance disappears given only 22.7% of self-reported diagnoses could be confirmed.
This might seem sufficient to consider the case for BII closed, and that doctors are right to dismiss their patients as suffering from symptoms that are either unrelated or entirely psychosomatic, but that may be too hasty. A recent literature review: ‘Breast Implant-Associated Immunological Disorders’ published in the Journal of Immunology Research in May this year anaylsed the cohort study alongside 5 other studies, seeking to characterise BII autoimmune disorders and determine possible causes. It concluded that there seems to be an association between autoimmune and systematic symptoms and breast implants in multiple studies over the past decades, but also interestingly, it points out that this association is not limited to breast implants.
So have Ru-Paul and Michelle Visage of Drag-Race fame her-story convinced me to go back to an A cup, and stuffing my bra with socks as they suggest? Probably not.
Association were also be found in other implants, such as orthopaedic implants, even when composed of other materials than the biologically inert (but labelled ‘toxic’ by HealingBreastimplantillness.com) silicone. This review confirms that explantation surgery appears to be the current gold standard for BII, but it’s a prospect that’s hardly feasible for Nana Winni’s new hip. One of the studies analysed indicated that bacterial biofilm is identified at a higher rate in women with BII, and calls for more study in this area.
So have Ru-Paul and Michelle Visage of Drag-Race fame her-story convinced me to go back to an A cup, and stuffing my bra with socks as they suggest? Probably not. But despite being lost in the weeds of wellness-woo, Visage has a point: people are unwell, and there definitely needs to be more research and more awareness of the association between implants and autoimmune disorders. Not just for those undergoing breast augmentation or other cosmetic surgeries, but anyone with medical implants. Hopefully, there will be less drastic and more effective solutions than explantation surgery and green juicing in the near future.
