For the first 10 years, Leslie Zakian's loved her breast implants. But then, around 20 years ago, she started experiencing a series of strange and increasingly alarming symptoms.
“I started experiencing these horrible night sweats," the 56-year-old said. "I started going to all kinds of doctors."
But they could not find the cause, so they moved onto bloodwork.
“They’d call me back and say, ‘Your blood levels are really off.' They sent me to an oncologist. I did all kinds of tests. The nuclear, the this, the that. Nothing [worked],” Zakian said.
She then got Bell’s palsy, a neurological disorder that causes paralysis or weakness on one side of the face — not once, but twice. Next, she said she started having problems with her eyes.
That's when she listened to a friend who had been urging her to research breast implant illness, or BII. She soon found a solution — and realized that she was not alone.
Thousands of women from all around the world have taken to social media to describe what they call their "BII journey," setting up groups like Breast Implant Illness Warriors, Fake Breasts, Real Women and Breast Implant Illness Mystery.
While breast augmentation is the second-most popular cosmetic procedure in the United States according to the American Society of Plastic Surgeons, a 2023 report found a 12% increase in breast implant removals over 2022.
A very real solution for many
The medical community has yet to acknowledge BII as an official diagnosis, but for so many women like Zakian it is very real.
Last December, the New Jersey Realtor came to Miami for her explant surgery — the removal of her implants.
She noticed the first change immediately.
“Normally, I used these eyedrops every single day to be able to open my eyes to wake up. I didn't use the drops. Look at me. I'm getting emotional. I haven't used them since,” she said.
Her plastic surgeon was Dr. Dev Vibhakar, or Dr. Dev, as he’s known in the explant community.
The founder and medical director of Aqua Plastic Surgery in Miami said his training and practice was initially focused on breast cancer and breast cancer reconstruction, as well as explant surgeries for cosmetic surgeries.
But as years went by, more and more women came to him complaining of BII symptoms. So, he said, he made a decision to stop doing breast augmentation surgeries.
“I just felt that [implants] were causing a lot of harm to patients. I just didn't feel right putting them in. And I became a big explant advocate and almost felt hypocritical if I would put implants in somebody and be such a big advocate for removing the implants. So I stopped completely,” Vibhakar said.
In his experience, symptoms can take anywhere from three months to 20 years to appear. Vibhakar recommends women first consult their primary care physician to make sure the symptoms are not related to any other conditions.
Not everyone who has breast implants will develop BII symptoms, and there is no guarantee that removing the implants will help, he said. The only way to find out is by removing them.
“The biggest fear is not feeling better after the surgery. Anecdotally, looking back, it ranges between 90% to 95% improvement, and that can range in a variety of symptoms from fatigue improvement and joint pain,” Vibhakar explained.
For Yaglin Medina, who lives in Miami, the improvement was dramatic and immediate.
The 40-year-old had her breast implants removed two years ago, after 17 years. She said before she made that decision, there were a lot of symptoms.
“Chronic fatigue, brain fog; low libido; chronic back, neck, shoulder pain; night sweats. I had swollen lymph nodes," Medina said. “I had very dry skin. My nails were very brittle. Shortness of breath. You know, it's just, it's quite, quite a long list.”
Today, she is a different woman, she said.
“All 44 symptoms that I had are completely gone. And I'm thankful and blessed for that,” she said.
Medina was an elementary school teacher for 14 years, and her experience led her to follow a new path as a nutritionist and BII advocate. She has created a support group for those dealing with BII and considering removing breast implants.
“This is a very lonely journey. It was for me. I've shared everything from day one and I created a support group where we can help each other. You are not alone. You have a friend in us,” Medina said.
While some doubt, others push for official diagnosis
Not all plastic surgeons agree with the correlation between symptoms and breast implants established by the BII movement.
Dr. Harry Salinas, the chief of breast reconstruction at the Cancer Center at Baptist Hospital in Miami, acknowledges the symptoms are real but said it is difficult to discern which ones are directly caused by the implants.
“Most of the literature has shown some association with these complaints and breast implants. But an association does not mean cause and effect," said Salinas, who performs around 500 breast procedures per year at a cosmetic surgery office.
Although in his experience some patients that remove implants “will get better,” the “overwhelming majority” don’t, he said.
According to Salinas, the “only ones that will get better are the ones that present with rheumatologic complaints, with autoimmune syndromes that started at the time of implant placement.”
“So it's a very challenging condition because although for a small subset of the population it is ‘real,’ the majority of the patients that complain don't get better when you explant them,” he added.
A breast explant is a major surgery and can cost anywhere from $7,000 to $15,000, but most insurance policies do not cover the cost because BII is not an official medical diagnosis.
For years, the National Center for Health Research has been working to get it recognized as a medical condition which would give it a code and pave the way for insurance companies to cover the procedure.
The number of women who decide to have their breast implants removed continues to grow, and they continue sharing their stories online to help others.
In October 2021, the Food and Drug Administration began requiring breast implant manufacturers to include information about the risk of symptoms that affect the whole body in a boxed warning on breast implant packaging.
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