Breast Implant Illness Symptom Resolution Over 24 Months After Explantation: A Prospective Observational Study.

BACKGROUND

Breast implant illness (BII) is an emerging but poorly defined clinical entity characterized by a constellation of systemic symptoms. While explantation is increasingly reported to improve outcomes, the temporal dynamics of symptom recovery remain insufficiently studied.

METHODS

We conducted a prospective single-center observational study of 20 women undergoing breast implant removal for suspected BII. Symptoms were categorized into four clusters-musculoskeletal, neurocognitive, constitutional, and dermatologic-and assessed at baseline and up to 24 months postoperatively using numeric rating scales. Patient-reported outcome measures (PROMs) were also collected. Longitudinal changes were analyzed with mixed-effects models, and time-to-resolution was evaluated using Kaplan-Meier analysis.

RESULTS

All symptom clusters demonstrated significant improvement compared with baseline (h < 0.01). Musculoskeletal complaints improved most rapidly, with substantial reductions by 3 months, followed by neurocognitive symptoms by 6 months. Constitutional fatigue improved more gradually, stabilizing by 12 months, while dermatologic symptoms showed the slowest trajectory, with maximal improvement between 18 and 24 months. Longer implant duration correlated with slower neurocognitive recovery (r = 0.41, p = 0.04), whereas implant type and surface texture showed no association with outcomes. PROMs demonstrated marked and sustained improvements in physical well-being and body satisfaction through 24 months. No major complications occurred.

CONCLUSIONS

Explantation is associated with durable symptom relief in patients with suspected BII, though recovery trajectories differ by symptom cluster. Musculoskeletal and neurocognitive domains recover rapidly, while constitutional and dermatologic symptoms may require longer to resolve. These findings highlight the heterogeneous nature of BII and underscore the value of cluster-based outcome assessment for patient counseling and management.

LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .