**Breast implant illness is too poorly understood to be dismissed out of hand** In the last few years an increasing percentage of patients have elected to have their breast implants removed- 34% from 2018- 2019 according to data provided by The Aesthetic Society.(1) Perspectives on self image; beauty, health and surgery are ever changing and this is reflected by increased dialogue and visibility of sets of symptoms referred to as breast implant illness (BII). These symptoms are wide ranging, described as including “… fatigue, chest pain, hair loss, headaches, chills, photosensitivity, chronic pain, brain fog and sleep disturbance.” (2) The broadness of individual experiences makes it hard to diagnose: at present, there is no diagnostic process in place specifically for BII. A further challenge is the limited clinical evidence, with bodies such as the FDA not finding any evidence for breast implants being associated with muscular pain, chronic fatigue or cognitive issues. (3) Anecdotally however; a number of patients who opt to have their implants removed have self reported the improvement of some symptoms, often immediately after. (4) If the removal of the implants resolves the symptoms, is it arguably a valid treatment? Patients should be able to seek appropriate treatment that is respectful of the very real physical; mental and emotional symptoms they are experiencing. Dissemination of experience and information is important in supporting and encouraging patients to seek medical help to address their concerns. That being said, there are some things to be wary of. In some online circles non-medical professionals have promoted en bloc removal of implants to limit “contamination” by the silicone. This form of explant is not an approach normally favoured by surgeons as it carries an increased risk of complication.(5) There is some suggestion by sources such as the BMJ that it might be “behaviourally mediated” and that behavioural interventions might provide some support: once again, people must be encouraged to seek advice from a medical professional in order to receive the appropriate treatment.(5) There are indeed complications associated with breast implants which must be thoroughly highlighted before surgery. It is also important that illnesses unrelated to the breast implants are not misidentified as BII. Though evidence for breast implant illness is scarce at this moment at this moment in time, it should be the subject of in depth ongoing research and claims should not be dismissed out of hand as purely psychosomatic. An obvious addendum to the above is that absolutely no one can provide a diagnosis without full; diligent investigation by a medical professional- and perhaps the entire point is that speculation by laymen online or in person are not a substitute for it. 1. https://www.surgery.org/sites/default/files/Aesthetic-Society_Stats2019Book_FINAL.pdf 2. https://www.bbc.co.uk/news/health-49033715 3. https://www.center4research.org/breast-implant-illnesses-whats-evidence/#:~:text=The%20FDA%20has%20repeatedly%20reassured,such%20as%20%E2%80%9Cchronic%20fatigue%2C%20cognitive 4. https://www.breastcancer.org/treatment/surgery/reconstruction/types/implants/special-report/breast-implant-illness 5. https://academic.oup.com/asj/article/40/9/NP561/5857569