In an Instagram reel shared on June 8, Youn held a silicone implant in one hand while pointing to the various symptoms that breast implants cause written in text over the video, including hair loss, brain fog, joint aches, rashes, fatigue and muscle pain.
Those are just some of the symptoms reported by patients who believe they are experiencing a sickness called breast implant illness (BII) which, according to most doctors, doesn't really exist. Youn contradicted his fellow doctors with this statement shown at the end of his Instagram post: "Not in everyone, but in some. BII is real."
"Throughout my training, I was told it [breast implant illness] was hogwash – and that's what I believed," said Youn, who has 17 years of experience in plastic surgery.
Youn noted that his most common procedure is breast implants. He had always been taught they were safe, but he heard about lawsuits as well as websites and social media groups of women sharing their stories and autoimmune symptoms following breast augmentation. (Related: Breast implants are hard on the immune system: More women reporting rare immune system cancer related to implants.)
"Breast implants can cause a constellation of symptoms in some women, called BII," he explained in his video post. "Yes, I believe it's real. But I also believe that most women do just fine with implants. But definitely not all."
Symptoms of BII may not appear for months after surgery and tend to reveal themselves slowly when they do. Aside from those mentioned in Youn's Instagram post, other symptoms of BII include inflammation, digestive issues, respiratory difficulties, dry mouth and eyes, depression, anxiety and insomnia.
Many doctors claim BII is not real
Many doctors have said that BII is not real and that the symptoms must stem from issues unrelated to the implants.
"Plastic surgery literature is not supportive of the notion of breast implant illness," Youn said, adding that early studies were "done by implant device companies and plastic surgeons."
Technically, the condition is not medically recognized as no studies have firmly concluded that the procedure and materials used for implants could prompt illness. This leads to a stigma suggesting that the patients just made up the illness.
According to Youn, one of his patients had been told by another doctor "to see a psychiatrist" when she shared her symptoms.
Symptoms associated with BII are similar to those caused by autoimmune and connective tissue disorders like rheumatoid arthritis, lupus and scleroderma. But the general cluster of BII symptoms doesn't seem to match any classic disease diagnosis. Some women with BII symptoms are eventually diagnosed with an autoimmune disease or a connective tissue disorder, but many are not.
Among the various BII hypotheses that have been explored to date, a leading theory is that some women may be genetically predisposed to developing an immune reaction to the materials used in breast implants. This theory is called autoimmune/inflammatory syndrome induced by adjuvants (ASIA).
The symptoms seen in ASIA are caused by a systemic reaction to adjuvants, such as silicone.
Explant may be the best cure for BII
Some patients have opted to go under the knife again and have their implants removed – also known as an explant – as a result of the illnesses that leave them feeling poisoned. No official diagnosis of breast implant illness can be given, but patients can always seek out an explant.
"Your body, your choice," said Youn.
In 2019, the Food and Drug Administration (FDA) issued a broad statement to medical device manufacturers that produce implants, saying that more thorough research on their products must be done. In 2020, the FDA made an update to their analysis of breast implant devices. (Related: FDA now admits breast implants only last 10 years and have to be removed in all women.)
"While the FDA doesn't have definitive evidence demonstrating breast implants cause these symptoms, the current evidence supports that some patients experience systemic symptoms that may resolve when their breast implants are removed. The FDA is committed to communicating information the agency receives about systemic symptoms reported by patients with breast implants," the agency wrote.
Awareness is key
There are about 400,000 breast augmentation procedures performed in the U.S. every year, but "so many women don't know about BII," said Youn. "Awareness is so important.”
Youn now uses his social media platforms to address the risks associated with breast implants and other cosmetic procedures. "You try to do right by your patients," he said.
His social media followers are thanking him for bringing more awareness to the issue. He has 4.6 million followers on TikTok alone.
"I was so sick," wrote one of his social media followers. "BII nearly killed me."
"Thank you for being so real," wrote another. "I've had many friends get theirs taken out because of symptoms like these, and their original plastic surgeons comment that it's probably not from the implants (even if they've had a full workup to rule out everything else)."
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