Understanding & Treating BII/SSBI

Breast Implant Illness (BII) and Silicone Sensitivity (sometimes called SSBI) describe a constellation of systemic symptoms—fatigue, joint pain, cognitive changes, and more—that some patients attribute to their breast implants. While research continues, many patients find relief through en bloc implant removal and capsulectomy. At Monarch Plastic Surgery & Skin Renewal Center in Sandy Springs—serving Buckhead and Atlanta—Dr. Carmen Kavali offers a comprehensive evaluation and “peace-of-mind” explant procedure tailored to each patient’s health needs and cosmetic goals.

• Breast Implant Illness (BII): A patient-reported syndrome encompassing chronic fatigue, muscle/joint aches, “brain fog,” gastrointestinal upset, skin rashes, and other nonspecific symptoms.
• Silicone Sensitivity (SSBI): An immune-mediated reaction to silicone components—either from gel bleed or low-grade leakage—manifesting as systemic or localized symptoms.
• Current Evidence: While large-scale causal links remain under study, many affected patients experience significant symptom improvement after implant removal and capsulectomy.

Both BII and SSBI are diagnoses of exclusion. A careful multidisciplinary workup is essential to rule out other medical causes before attributing symptoms to implants.

Consider an evaluation if you:

• Have persistent unexplained symptoms—fatigue, joint/muscle pain, autoimmune-like manifestations, rashes, or cognitive changes
• Noticed onset or worsening of symptoms months to years after implant placement
• Tried medical therapies without lasting relief
• Seek definitive answers and potential symptom improvement
• Are in good overall health, or willing to optimize medical conditions before surgery

Ideal candidates undergo rheumatologic or allergy evaluation to exclude other diagnoses and enter a shared decision-making process about explantation.

• Comprehensive Symptom Review
  • Timeline of symptom onset relative to implant surgery
  • Impact on daily activities and quality of life
• Medical Workup Coordination
  • Laboratory testing (autoimmune panels, inflammatory markers)
  • Imaging (ultrasound or MRI to assess implant integrity and possible silicone bleed)
  • Referrals to specialists (rheumatology, dermatology, gastroenterology) as indicated
• Surgeon Evaluation
  • Physical exam of breast appearance, implant position, and any local signs (capsular firmness, redness)
  • Discussion of your goals: total implant removal, capsulectomy extent, and potential need for aesthetic restoration (lift or fat grafting)
• Detailed Education
  • Review of en bloc versus total capsulectomy techniques
  • Risks and benefits of explant surgery, including changes in breast shape and sensation
  • Alternative or adjunctive treatments (medical, dietary, lifestyle modifications)
• Personalized Surgical Plan
  • Implant pocket location and incision choice (inframammary, periareolar, or axillary)
  • Choice of en bloc removal when feasible (removing implant plus intact capsule)
  • Decision on bilateral versus unilateral removal if only one side is symptomatic
  • Optional immediate breast lift or fat transfer for aesthetic contour

Your comfort and confidence are paramount—this consultation is an opportunity to address all questions and map out a clear path forward.

• Capsulectomy Technique
  • En Bloc Capsulectomy: Implant and capsule removed in one intact specimen—preferred for ruptured or textured implants
  • Total Capsulectomy: Complete removal of the capsule in pieces when en bloc is not feasible
  • Capsulotomy: Partial release of the capsule only—less common when systemic symptoms are the driver
• Incision Strategy
  • Inframammary: Hidden in the breast fold—direct access for thorough removal
  • Periareolar: Scar around the areola; extra caution to preserve nipple sensation
  • Transaxillary: Armpit approach—avoids breast scars but limits visualization for complete capsulectomy
• Aesthetic Restoration
  • No Immediate Lift: Accept natural deflation if the post-explant shape is acceptable
  • Concurrent Mastopexy: Lift sagging skin and reposition the nipple—recommended when tissue longevity and shape are priorities
  • Fat Grafting: Use autologous fat to restore volume and smooth contour—no implants needed
• Post-Explant Support
  • Garment Selection: Soft support bras to minimize movement and swelling
  • Wellness Plan: Nutritional supplementation, physical therapy, or integrative medicine referrals to support systemic recovery

• Anesthesia & Markings
  • General anesthesia for patient comfort
  • Mark implant footprint, incisions, and lift patterns if planned
• Incision & Pocket Exposure
  • Open previous implant scar or make a new inframammary incision
  • Dissect down to the implant capsule under direct vision
• Capsulectomy & Explantation
  • En Bloc Technique: Remove the capsule and implant together in one intact specimen
  • Total Capsulectomy: Excise the capsule in segments to ensure complete removal of silicone and inflammatory tissue
• Pocket Irrigation & Assessment
  • Thoroughly irrigate the pocket with antibiotic solution
  • Inspect for residual silicone or inflammatory debris
• Aesthetic Closure
  • If performing mastopexy: Excise excess skin, reposition the nipple–areola complex, and lift the breast mound
  • Or simply close the pocket to allow natural deflation
  • Use multilayer absorbable sutures to optimize scar quality
• Dressing & Garment
  • Apply Steri-strips and light adhesive dressings over incisions
  • Fit a soft support bra to minimize motion

Duration: 1–2 hours (longer if lift/fat grafting is performed)
Setting: Accredited outpatient surgical suite—same-day discharge with a responsible escort

• Medical Clearance: Labs and any specialist clearances (rheumatology, dermatology)
• Medication Review: Hold blood thinners per protocol; optimize nutritional status
• Lifestyle Adjustments: Cease smoking/vaping four weeks before and after; avoid alcohol one week pre/post-op
• Support Logistics: Arrange home assistance for 48–72 hours; set up pillows, ice packs, easy meals, and entertainment

Days 1–3

• Mild discomfort managed with prescribed analgesics and cool compresses
• Rest with upper body elevated; avoid arm lifting or twisting

Weeks 1–2

• One-week follow-up: Assess incisions, ensure no fluid collection
• Continue support bra; light walking encouraged

Weeks 3–6

• Swelling subsides; scars begin to mature
• If lift performed, begin gentle scar massage as directed
• Resume desk work; defer vigorous exercise until cleared

Months 2–6

• Final breast shape stabilizes by three to six months
• Ongoing support garment use for high-impact activities
• Wellness follow-ups to monitor systemic symptom improvement

Strict adherence to Dr. Kavali’s post-op protocol supports both cosmetic healing and systemic recovery.

Benefits:

• Removal of silicone source potentially alleviates BII/SSBI symptoms
• Improved peace of mind and psychological relief
• Opportunity for breast reshaping or lift in the same surgery

Risks:

• Bleeding or hematoma—rare, may require drainage
• Infection—minimized by sterile technique and antibiotics
• Scarring—managed with meticulous closure and sun protection
• Possibility of persistent symptoms if etiology is multifactorial

Dr. Kavali reviews all safety considerations to ensure you make an informed decision.

Many patients benefit from a holistic recovery plan:

• Nutrition & Supplements: Anti-inflammatory diet, vitamin D, omega-3s
• Physical Therapy: Gentle exercises to restore posture and mobility
• Mind–Body Practices: Meditation, acupuncture, or biofeedback for symptom management
• Regular Check-Ins: Coordinate with your primary care provider or specialists to track symptom changes

For explant and capsulectomy in Sandy Springs, Buckhead, or Atlanta, verify:

• Board Certification: American Board of Plastic Surgery
• Explant Expertise: Proven experience with en bloc capsulectomy and BII/SSBI protocols
• Accredited Facility: AAAASF or Joint Commission accreditation
• Before-and-After Results: Examples of explant alone and explant with lift/fat graft
• Patient Testimonials: Praise for technical skill, compassion, and systemic support

Dr. Carmen Kavali’s specialized training and our state-of-the-art suite ensure your highest level of safety, comfort, and satisfaction.

Ready to explore whether explant and capsulectomy can relieve your symptoms? Contact Monarch Plastic Surgery & Skin Renewal Center:

• Call: 404.250.3333
• Email: info(at)drkavali(dotted)com
• Visit: 6045 Barfield Rd, Suite 100, Atlanta, GA 30328
• Online: Request a Consultation

Your personalized consultation will include a thorough health review, imaging if needed, and a clear surgical roadmap—helping you take the first step toward relief, balance, and renewed confidence.