Category Archives: Have Questions?

What is Breast Implant Illness?

“Breast Implant Illness” is the term frequently used by women whose breast implants have caused a pattern of debilitating symptoms, such as joint pain, “brain fog,” fatigue, and other flu-like symptoms that don’t go away.  Many but not all these health issues seem to be related to autoimmune disorders or connective tissue diseases.  Breast implant illness is not a medical diagnosis and most plastic surgeons reject the term.  However, many women with this pattern of health problems report that they recovered dramatically (sometimes completely) after their breast implants were removed.

For more information about the typical symptoms of breast implant illness, see  For a more detailed understanding of the research on these symptoms, see our 2018 report at

Breast Implants Have Harmed Me. How Can I Report this to the FDA?

Breast implants do not last a lifetime and many women report complications that they did not expect. Many women with breast implants experience implant rupture, capsular contracture, breast or body pain, joint pain and other autoimmune symptoms, mental confusion, rashes, and even cancer of the immune system (ALCL). If you have experienced any of these complications, you could help other women by reporting it to the FDA.

The FDA is responsible for protecting patients and consumers by warning them about the risks of medical products, and taking products off the market if the risks outweigh the benefits.  The main way they gather information about the risks of breast implants (and other types of implants) is when doctors, nurses, and patients report problems through the FDA’s Voluntary MedWatch Report. If the FDA sees that complications are more serious or more frequent than expected, we will urge them to require manufacturers to conduct better research or to pull the product from the market.

You can report any problems caused by your breast implants using this short online form.

You don’t need to remember exactly when the symptoms or complications started, but give an estimate of how long it was after you got your implants.  If you don’t know the exact brand or model of your implant, you should report your problems anyway, but include the brand if you can.  From 2000 to 2015, most breast implants in the US were made  by either Mentor or Allergan (also called Inamed or McGhan).

If you are in Canada, you can report medical device complications to Health Canada using this short online form.

If you have problems completing the form, ask for help at

Should I Get Silicone or Saline Implants? 

All breast implants have risks. The most common is when the breast gets hard and painful, known as capsular contracture. Many women with implants have that problem after a few years, but it appears to be more common with silicone gel breast implants than saline implants.

Implant surgery usually costs between $5,000-8,000, including the implants and one follow-up visit. Silicone gel breast implants cost about $1,000 more than saline implants.

However, there are a lot of extra expenses that you need to be aware of.

For example, saline implants and silicone implants both have a high complication rate, and almost half the women will need additional surgery to fix implant problems within 3-4 years. Some problems are cosmetic and some problems are more serious, such as infections, allergic reactions, or auto-immune reactions. That additional surgery often costs $5,000 or more. That is why we suggest that women considering breast implants make sure they have at least $5,000 in their savings that they will save and not spend until they need it for their next implant surgery.

All breast implants will eventually break, but when saline implants rupture it is obvious (they deflate quickly) and when silicone gel breast implants break, there are often no symptoms at first. Having no symptoms might seem like an advantage, but it is actually dangerous because silicone can leak out of the tear in the implant, and get to parts of the body where surgeons can’t remove it. Leaking silicone can cause pain and allergic or auto-immune reactions. When it is removed, the breast may be deformed.

Because of concerns about leaking silicone, the FDA recommends having breast MRIs regularly to detect ruptures that have no symptoms.  When silicone breast implants were first approved, the FDA recommended that all women undergo a breast MRI 3 years after getting breast implants, and every other year after that. However, because of the expense and the reluctance of plastic surgeons to encourage MRIs for silent ruptures, very few women followed the FDA’s advice.  As of October 2020, FDA now recommends an MRI 5-6 years after the initial surgery and every 2-3 years after that. Unfortunately, breast MRIs cost about $2,000 each, sometimes more. That may seem very expensive, but it is the only accurate way to know if your implants are broken or leaking. If they are leaking, it is important to have them removed immediately.

Given the expense and the risks, why would any woman get silicone gel breast implants? There is one advantage: they feel more like a real breast. Saline implants may not feel as warm as the rest of the body in cold weather (A figure skater told us they were painfully cold!). And, women with saline implants sometimes say that they sometimes make swooshing water noises. Most plastic surgeons prefer silicone gel implants because they tend to look and feel more natural. However, many women tell us that does not make up for the added risks and added costs.

It is important to know that all breast implants – saline or silicone – can cause serious health problems. They can even cause a type of cancer of the immune system, known as anaplastic large cell lymphoma (ALCL).

The bottom line: all breast implants will eventually break or cause other complications that will require additional surgery. Some complications can be very serious. But some breast implants are safer than others, and since silicone gel breast implants are more likely to leak unnoticed as they get older, we believe that saline implants are safer.

Are “Gummy Bear” Breast Implants the Safer Implants?

“Gummy bear” implants are silicone gel implants with a thicker, more cohesive gel that has the consistency of a gummy bear candy. Initially, these implants were thought to be safer than other breast implants because the more cohesive gel made them less likely to break or leak.

However, research now shows that gummy bear implants are probably not safer than other breast implants.  For example, one 5-year study by the implant company found the rupture rate of gummy bears in first-time augmentation patients was over 4%. The study also found that within the 5 year period between 17% and 48% of women needed additional surgeries, depending on whether the patient was getting cosmetic augmentation or reconstruction after mastectomy, and whether the gummy bear implants replaced previous implants.

Like other silicone gel implants, gummy bear implants may rupture without any obvious symptoms (called silent rupture). Because most women don’t notice when a silicone gel implant ruptures, the FDA recommends that women have a breast MRI 3 years after getting breast implants. After that, a woman should have a breast MRI every other year to check for a rupture or leak.

When a medical device causes a problem in a patient, the doctor, nurse, or patient can voluntarily report it to the FDA.  From January 1, 2008, through June 30, 2017, 19% of all adverse event reports made to the FDA for silicone breast implants involved gummy bear implants. That is a very high percentage when you keep in mind that gummy bear implants were relatively rare in the U.S. prior to 2012.  In other words, gummy bear implants are causing problems after just a few years – perhaps even sooner than other breast implants.

NCHR’s President, Dr. Diana Zuckerman, along with colleagues Madris Tomes and Amelia Murphy, wrote a book chapter about breast implants. Read a summary of the book chapter here. Copies of the entire book chapter are available upon request at

Why Are Celebrities Removing Their Breast Implants?


Celebrities who removed their breast implants

Have you noticed how many celebrities are in the news announcing their decisions to remove their breast implants?  They usually talk about the importance of loving yourself the way you are and they often post Instagram pictures of “the new me.”

But most of these women aren’t just talking about body image — they are getting their implants removed because of their health. Breast implants can make some women so sick that removal is their best hope for feeling like themselves again.  Several celebrities are trying to share their experiences in order to help other women.

crystal_hefner_2014Crystal Hefner, Hugh Hefner’s wife, opened up about her breast implant horror story on Facebook. She announced her implants had been slowly poisoning her and causing unexplained back pain, cognitive problems, constant neck and shoulder pain, frequent infections, and many other symptoms. After removing her breast implants, she instantly felt an improvement and continues to feel better. Read more about her story here.

Yolanda Foster, of Real Housewives fame, removed her breast implants when she found out her silicone implants had ruptured and were leaking into her body. The silicone was making the symptoms of her Lyme disease even worse. She felt much better once she removed her implants.

Linda Blair, actress in the horror movie The Exorcist, described her experience with breast implants as a nightmare. After removing her implants, she advocated for the FDA to make sure breast implants are actually studied to be safe.

Mary McDonough, a child star in The Waltons who appeared as an adult in shows such as ER and Will and Grace, attributes her autoimmune disease (lupus) to her breast implants. She was healthy before getting implants, and it was only after her implants were removed that she immediately started to feel better. She has been one of the most outspoken celebrities on the risks of breast implants.

Karen McDougal is a former Playboy Playmate and now a model who had her implants removed after months of feeling sick. She has spoken out about the risks of breast implants in USA Today and People Magazine. This was well before she became known for her relationship with Donald Trump.

Stevie Nicks, the singer/songwriter and former lead singer of Fleetwood Mac, decided to have her implants removed because she believed they were causing extreme fatigue and lethargy.  After removal, Nicks told People Magazine “I’m living proof they aren’t safe. It turned out they were totally broken.”

Nicola Robinson, the Australian model and wife of prominent chef Pete Evans, decided to have her implants removed because she was so ill. Robinson told Australian TV show Sunday Night that “I knew 100 percent that they were making me sick and essentially ageing me. So it just made perfect sense to me that they had to go. There’s just so many advantages to not having two large bags attached to your chest.”

Melissa Gilbert, actress and producer, decided to have her implants removed fearing they would rupture. She told People Magazine, “What am I going to do when I’m in my 80s and I have to have a hip replacement but I also have my breast implants replaced? Because it’s inevitable, they have a life span. So I wanted them out.”

Mariel Hemingway, Kimberly Holland, and Heather Morris are among other celebrities who chose to remove their breast implants because of serious health problems.

Celebrities are bringing attention to the health problems that thousands of women with implants have suffered from for decades.

So, what usually goes wrong?

You can learn more about the risks and complications associated with breast implants here.

Besides health problems, some celebrities decide to remove their implants simply because they were annoying or embarrassing. Just to name a few, Heather Morris, Heidi Montag, Pamela Anderson, and Victoria Beckham all removed their implants for this reason.

If you’re considering getting breast implants, click here for more information.

If you’re considering removing your implants, click here for more information.

What if I Need to Get My Implants Removed?

If you want or need to get your implants removed, it is best to choose a board-certified plastic surgeon. Choosing a plastic surgeon to perform your explant surgery requires careful consideration because removal is a more complicated procedure than placing implants.

If you are having any problems with your breast implants, it is especially important to find a surgeon who can remove your implants with great skill. Your surgeon needs to be able to minimize any leakage or other potential problems resulting from the surgery. For more information on finding an experienced plastic surgeon to remove your breast implants, click here.

You may also want to know if insurance will cover the costs of removal. Insurance companies cover services that they determine to be “medically necessary” to treat a disease or illness.  Although you or your doctor may believe a service is medically necessary, insurance companies don’t always agree.

Many companies consider removal of breast implants medically necessary for patients with any of these conditions:

Unfortunately, insurance companies generally won’t cover the cost of breast implant removal for autoimmune or connective tissue diseases or other systemic complications.

Obtaining coverage for your implant removal differs depending on the type of insurance you have. Medicare and Medicaid also cover implant removal that they consider medically necessary. To learn more about trying to get insurance coverage for removal, click here.

The National Center for Health Research is running a free program to assist women to get health insurance coverage to remove their breast implants. If our assistance is something you might be interested in, please fill out this very short survey and we will be in touch with you soon.

Legal Action

Currently, there are no open class action lawsuits relating to implants. Because most women getting implants are asked to sign informed consent documents prior to their surgery, it has become very difficult for lawsuits to proceed. Recently, however, the number of individual lawsuits against breast implant makers has increased. If you believe you may have a claim against an implant manufacturer, you may want to speak to a lawyer who has experience with this type of case.

All articles are reviewed and approved by Diana Zuckerman, PhD, and other senior staff.

I Have Been Diagnosed with Breast Cancer. What Are My Options so That I Can Still Have Breasts?

We’re not doctors and we don’t provide medical advice, but I can tell you what we know based on research and from speaking with many experts and with women who have had breast implants.

If you have been diagnosed with early stage breast cancer (stage I, IIa, IIb, or IIIa) , you may be able to keep your breasts, and have a lumpectomy rather than a mastectomy (which removes the entire breast). Studies show that early-stage breast cancer patients who undergo a lumpectomy (which removes only the cancer and a small area around it) and radiation will likely live just as long as women who have a complete mastectomy. 

If you have been diagnosed with a pre-cancerous condition such as Stage 0 breast cancer, including ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS), it is unlikely that you need a mastectomy. Women with LCIS do not have breast cancer and most will never get breast cancer, though they do need regular mammograms.

Breast Reconstruction Options after Mastectomy

If a woman needs to have a mastectomy, there are several choices for reconstruction. Many breast surgeons and breast cancer patients believe that breast reconstruction is an important step in recovering physically and mentally from a mastectomy.

Breast implants are the most common form of breast reconstruction after mastectomy. This is probably because breast implants are the easiest form of reconstruction and most plastic surgeons are not skilled enough to perform the other types of breast reconstruction discussed below.  There are silicone gel breast implants and saline breast implants on the market, and both options have a high complication rate for reconstruction patients. Some of the most common complications of breast implants include implant rupture, capsular contracture (painful hardening and abnormal shape of the breast), breast painautoimmune symptoms, and interference with mammography for breast cancer screening. In addition, women who have breast implants, either for mastectomy or healthy breasts, are more likely to develop a type of lymphoma (cancer of the immune system) called ALCL.

An alternative to breast implants is autologous tissue transfer (also known as a flap or flap procedure), where the body’s own tissue is used to reconstruct breasts. There are various types of autologous tissue transfer.

Flap reconstruction with muscle and fat, also called the TRAM flap, uses muscle and fat from the abdomen. Reconstruction methods using fat and muscle create a more natural looking reconstruction than those using only fat due to their added firmness.   Also, the larger amount of tissue used during muscle and fat reconstructions enables the surgeon to create larger breasts than those with fat only.

Surgeons can also perform flap reconstruction with fat only, also called the DIEP Flap, which takes skin, vessels, and fat from the abdomen.  Surgeons can take tissue from most areas of the body that have a large fat supply. Reconstruction with only fat takes more time than other procedures because the tissue has to be harvested and removed from the body before the reconstruction can take place. To be a good candidate for this procedure, women need more body fat to create the breast.

The last option for flap reconstruction is commonly called the Lat Flap, and uses the latissimus dorsi (upper back muscle) to reconstruct breasts. This procedure is more likely to fail than some other flap procedures, but less likely to have surgery-related complications or need reoperations within the first two years. However, since the latissimus dorsi is a large and important back muscle, the procedure can lead to serious difficulties moving, lifting, or performing strenuous exercise.

The decision of which reconstruction option to choose, if any, is a personal one.  To make an informed choice, however, patients need to meet with breast surgeons who are skilled at the different options.  Since most breast surgeons only know how to do reconstruction with breast implants, they don’t usually provide good information to their patients about the benefits of other options. You can read more about each of these options for breast reconstruction here.


All articles are reviewed and approved by Diana Zuckerman, PhD, and other senior staff.

I’m a Teenager Considering Breast Implants. What Should I Know to Help Me Decide?

Here are a few things to consider as you are making a decision about getting breast implants:

Teenagers are not finished developing. Breasts can develop during the late teens and early 20s. Implants could interfere with your normal development, or the resulting size and shape could be not at all what was intended as the breasts continue to develop.

The body you wish you had in your teens might not the body you’re going to want in your 20s.

Teenagers are often self-conscious about how they look. The odds are that you will feel a lot better about your body just a couple of years later, even without any cosmetic surgery. In fact, women who have breast implants tend to feel worse about themselves. Research has shown that of all age groups, teenagers are the most likely to be dissatisfied with their appearance — and that the dissatisfaction lessens with age. A long-term study conducted on both boys and girls ages 11-18 found that body image satisfaction was highest at age 18 for both boys and girls. In other words, older teens feel better about their bodies than younger teens.1 The study also found that the features participants were most dissatisfied with reflected the culturally determined stereotypes emphasized in books, mass media and advertisements.

There are no epidemiological studies or clinical trials on the safety and long-term risks of breast implants and liposuction on patients under 18. So, the risks are unknown. Although the FDA approved silicone gel breast implants only for women ages 21 and older, and saline breast implants only for women 18 and older, there are no legal restrictions on the procedure. The American Society of Plastic Surgeons has an official position against breast augmentation for most teens under 18.

Breast augmentation has a very high complication rate that often requires additional surgery within five to ten years.2 , 3 For a girl of 18, that means she will probably need another surgery while she is in her 20s, her 30s, and every decade after that.

Some women do fine with breast implants while others have complications or health problems that can make them so sick that they call implants “the worst decision I ever made.” Before you decide, make sure you understand the risks and complications of breast implants.

Click here to read about a woman who got her implants when she was young and what she thinks about them today.

All articles are reviewed and approved by Diana Zuckerman, PhD, and other senior staff.

After Years of Being Unhappy with My Breasts, I Am Thinking of Getting Breast Implants. What Are the Risks?

Breast implant surgery comes with a high complication rate. Complications can happen immediately after the surgery or years after. The major health risks of breast augmentation surgery are:

Capsular Contracture – The most common complication of breast implants is capsular contracture. Capsular contracture occurs when the scar tissue tightens around the breast implant. This can cause the breast to feel hard and very painful.

Breast Pain, Redness, or Swelling – As with any surgery, augmentation patients should expect to feel pain immediately after surgery. However, pain that lasts for months or longer can have many different causes and requires treatment. It can be a sign of an infection, especially if the pain is accompanied by redness, swelling, and tenderness. Or it can be a sign of nerve damage, which can be temporary or permanent. The weight of breast implants can strain the muscles in your neck, back, and chest and can cause chronic back pain and shoulder pain, and can even cause permanent damage.

Rupture – If a breast implant tears or develops a hole, it is called a rupture. Some ruptures happen during the first few months, but the older an .implant is, the more likely it is to rupture. It’s not always obvious when an implant has ruptured. Here’s what you need to know. Link?

Autoimmune Symptoms and “Breast Implant Illness”  Breast implant companies were required to complete safety studies before they could sell their implants in the United States. When the Food and Drug Administration (FDA) approved breast implants, they admitted that “studies would need to be larger and longer” to find out if implants could cause the kinds of symptoms and diseases many women were reporting, such as joint pain, “brain fog,” fatigue, and other flu-like symptoms that don’t go away. These health issues seem to be caused by autoimmune or connective tissue problems, and many women with these and other symptoms refer to them as “breast implant illness.” Breast implant illness is not a medical diagnosis and most plastic surgeons reject the term. However, many women with this pattern of health problems report that they recovered dramatically (sometimes completely) after their breast implants were removed.

Interference with Breast Cancer Detection – Breast implants make it more difficult to detect breast cancer when they hide cancer tumors. If you are considering getting breast implants or already have breast implants, it is important to know how they can make mammography and breast exams less accurate.

Infection – Infections can happen after breast augmentation surgery if bacteria get into the incision site. Or bacteria can thrive around and implant. These infections can be serious. The Food and Drug Administration (FDA) warns that toxic shock syndrome, a life-threatening complication from bacterial infections, has been reported following breast augmentation surgery.

Pregnancy and Breastfeeding Concerns – Pregnancy can cause drastic changes in breast size and shape, so having implants may affect the shape of breasts after the baby is born. In addition, women with breast implants may find it difficult to produce enough milk due to pressure on the milk ducts from implants or damage to mammary glands or ducts during the implant surgery.

Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) – Cancer experts agree that women with breast implants are more likely to develop ALCL, a rare cancer of the immune system that develops in the scar tissue (capsule) that forms around a breast implant.

Extrusion – Extrusion, or when a breast implant comes through the skin and becomes exposed, is an uncommon, but dangerous, complication of breast implant surgery.

In addition to the health risks, there also are financial costs. For more information about the costs of breast implants, click here.

All articles are reviewed and approved by Diana Zuckerman, PhD, and other senior staff.

How Do I Find Out If My Silicone Gel Breast Implants Are Leaking, and What Should I Do If They Are?

If your silicone gel implant ruptures, you might – or might not – notice a change in the size or shape of your breast. You might feel pain, tenderness, swelling, numbness, burning, or tingling on or around your breast. However, you might not have any symptoms, and might not realize that your implant is broken and possibly leaking. This can be harmful to your health, and the longer the implant is leaking silicone in your body, the more harm it can cause.

The best way to know whether your silicone breast implant has ruptured is to have an MRI with a breast coil. Unfortunately, MRIs are expensive and MRIs to check for implant rupture may not be covered by insurance.

Because most women don’t realize that a silicone gel implant has ruptured,  the FDA recommends having breast MRIs regularly to detect ruptures that have no symptoms.  When silicone breast implants were first approved, the FDA recommended that all women undergo a breast MRI 3 years after getting breast implants, and every other year after that. However, because of the expense and the reluctance of plastic surgeons to encourage MRIs for silent ruptures, very few women followed the FDA’s advice.  As of October 2020, FDA now recommends an MRI 5-6 years after the initial surgery and every 2-3 years after that. That way any leaks can be caught early, helping to protect your health.

A mammogram is not usually an accurate way to diagnose a ruptured silicone-gel breast implant. In addition, the pressure from mammography could cause the implant to break and could cause a broken implant to leak.

If even one of your silicone gel implants is ruptured, it should be removed as soon as possible. The longer the silicone is leaking into your body, the more time it has to migrate to your other organs, such as your lungs or liver, or even your brain. When that happens, the silicone can be impossible to remove.

To read more about breast implant ruptures or leakage, click here. To read more about removing ruptured breast implants, click here.

All articles are reviewed and approved by Diana Zuckerman, PhD, and other senior staff.