Response of locoregional and systemic symptoms to breast implant replacement with autologous tissues: experience in 37 consecutive patients.

This paper addresses the effectiveness of implant removal as treatment for systemic symptoms perceived to be related to breast implants. We reviewed our experience with 37 consecutive patients who underwent autologous tissue replacement of reconstructive breast implants. All patients were motivated primarily by concern regarding systemic symptoms for which diagnoses could not be provided. The majority of treated patients also had locoregional complaints and physical findings suggestive of either implant failure or symptomatic contracture and/or inflammatory disease. Essentially all patients with locoregional symptoms experienced improvement or resolution of these throughout the period of follow-up (6 to 27 months). However, relief from systemic complaints proved short-lived, with a 90 percent early response rate falling to 32 percent by 6 months postoperatively. We continue to strongly counsel patients to pursue reoperation only when locoregional symptoms are persistent and associated with physical or radiographic findings of significant contracture or implant failure. We conclude that although explantation with or without autogenous reconstruction may be appropriate in certain circumstances, it should not be proposed as a treatment for systemic rheumatologic or neurologic complaints.