Understanding Breast Implant Illness: A Current Perspective and Concise Review

A bstract Breast implant illness (BII) describes a diverse spectrum of non-specific systemic symptoms attributed to breast implants. Despite the absence of formal diagnostic criteria, the rising frequency of patient presentations and requests for explantation necessitates a structured, evidence-based appraisal of current perspectives. This narrative review, guided by a documented search strategy and selection flowchart, identifies four primary pillars of BII research: the silicone adjuvant theory, the foreign body reaction, the biofilm hypothesis and psychosocial components. A critical synthesis of these mechanisms indicates that while the foreign body reaction is a universal biological response, the systemic symptoms of BII likely involve multifactorial drivers, including environmental stressors and health-seeking behaviours influenced by digital advocacy. Clinical outcomes following explantation show high rates of symptomatic relief; however, these findings are primarily derived from patient-reported outcomes, as high-level randomised controlled data remain absent. Furthermore, the clinical landscape has been significantly redefined by recent regulatory actions, including the Food and Drug Administration’s mandated “black box warning” and the clear pathological distinction between BII and breast implant-associated anaplastic large cell lymphoma. Management requires a biopsychosocial approach, prioritising individualised surgical strategies—such as total capsulectomy—rather than mandatory “en bloc” resections, which lack a definitive evidence-based superiority. Ultimately, clinicians must maintain a patient-centred dialogue that acknowledges the current limitations of biomedical evidence while addressing the multifaceted nature of the condition.