Abstract
BACKGROUND: Explantation of breast implants is increasingly performed in response to concerns about breast implant illness (BII), an array of various health symptoms. However, the benefits of explantation remain unclear because of methodological limitations in previous studies. OBJECTIVES: To examine the occurrence of health symptoms before and after explantation of cosmetic breast implants. METHODS: This is a retrospective cohort study linking data from the Dutch Breast Implant Registry and Nivel Primary Care Database. The study included 217 cosmetic explantation patients, control groups of 228 cosmetic replacement patients, and 433 female patients without breast implants (nonrecipients). BII-related health symptoms presented in general practice were compared between groups 1 year before and after explantation. Outcomes included any symptom, ≥2 symptoms, ≥3 symptoms, ≥3 consultations, and substantial symptoms (≥3 symptoms with ≥2 consultations for 2 symptoms). RESULTS: The likelihood of ≥3 symptoms, ≥3 consultations, and substantial symptoms reduced significantly after explantation (odds ratio [OR] ≥3 symptoms 0.26, 95% CI [0.08-0.85]; OR ≥3 consultations 0.56, 95% CI [0.32-0.96]; OR substantial symptoms 0.36, 95% CI [0.14-0.94]). However, compared with nonrecipients, explantation patients still had higher odds of any symptom, ≥2 symptoms, and ≥3 consultations after explantation. Replacement patients also had a reduced likelihood of any symptom, ≥2 symptoms, and ≥3 consultations from pre- to postsurgery. CONCLUSIONS: Although explantation appears to improve BII-related health symptoms within a year, patients still showed an increased likelihood of symptoms compared with nonrecipients.