Silicone prosthesis removal grows in Brazil, reflects new feminine perspective

RIO DE JANEIRO, BRAZIL – When women first began to get silicone breast implants, nothing was discussed about how to remove them. Today, driven by the sharing of information on social media, implant removal has become a phenomenon in the world leader in plastic surgery.

Actress Gabriella Britto, 30, described her experience with removal in January on social networks after 9 years with silicone. “My decision was based on thinking that maybe something external could make me feel better,” she says. “There was and still is a difficulty in showing women’s real bodies. We start to think we have some kind of problem.”

In the past 4 years, lifestyle changes, such as adhering to veganism, made her rethink the need for silicone. “I had a foreign body, which could cause damage, and I felt I didn’t need it anymore.”

The number of breast implant removals increased 33% in Brazil, according to data from the International Society of Plastic Surgery. It rose from 14,600 in 2018 to 19,400 in 2019 – the latest figures available. Breast augmentation remains one of the flagships of plastic surgery in Brazil, with 211,000 procedures a year, but demand has been dropping.

Brazilian doctors who specialize in explantation say that the search for removal boomed in 2020, despite the pandemic, and is still on the rise. Each week, plastic surgeon Bruno Herkenhoff performs between 4 and 5 surgeries. He says that even for him, at first, removing the silicone demanded an effort to change the mindset about beauty. “We need psychological care to change this paradigm that comes from our training,” he says.

Journalist Camila Ermida, 42, reports a “love-hate relationship” with silicone, implanted in 2017, until she had it removed in August. She had tinnitus in her ears, hair loss, and cold feet and hands. A capsular contracture was also detected in one breast, still in a mild stage – when the membrane formed by the body around the silicone starts to compress the prosthesis. “It was a preventive choice. I didn’t wait to present other symptoms.”

The physical changes she noticed are part of a list of symptoms reported by other women with breast implants. The so-called “silicone disease,” which encompasses these symptoms, is not recognized as an illness by the medical profession. But a significant number of women who have had implants report an increase in at least some of the symptoms.

Another syndrome associated with prosthesis is ASIA (adjuvant-induced autoimmune-inflammatory syndrome), described in 2011 by an Israeli researcher. It consists of the development of autoimmune diseases.

Plastic surgeon Ricardo Eustáchio de Miranda says that today it is more common for women to come to his office to remove rather than insert silicone. Many of them come with symptoms of ASIA, he says. “I believe in the symptoms. The question is whether they are related to the prosthesis or not. We have to investigate. By ruling everything out, we remove it (the silicone), but I always say that there is no guarantee that removing the prosthesis will improve the symptoms.”

Miranda assists patients in Guarulhos and São Paulo and is recommended by other women who have had implants – he performs 350 of these surgeries a year, including patients from other cities.

SOCIAL NETWORKS BOOST THE TREND

Doctors who perform explantations emphasize the role of sharing information on social networks for decision making. In addition to websites that compile reports of health issues associated with prostheses, influencers on the Internet are challenging beauty standards and also supporting the trend.

In recent weeks, the sharing of information by influencers about removing prostheses has fueled the debate. Actress Fiorella Mattheis, who underwent removal surgery this year, told her 3 million followers on Instagram about the experience. “It’s important that we love ourselves,” she wrote. She reported pain in her breast.

Writer Alexandra Gurgel, founder of the “Movimento Corpo Livre” (Free Body Movement) and author of the book “Pare de se odiar” (Stop hating yourself), also announced that she intends to have an explantation. On her social media channels like Instagram and Facebook, with 1 million followers, she criticizes the beauty standards imposed on women and fatphobia.

Brazilian Society of Plastic Surgery (SBCP) president Dênis Calazans says that the entity’s perception is that the implant removal is more discussed than it actually occurs. He says there is “scaremongering” in reports about health issues related to prostheses and that there is still “little scientific evidence” about it.

According to Calazans, the number of patients who benefit from prostheses is much higher than those who choose to remove them. The SBCP does not have specific data on implant removal, but its next census will map the increase in these surgeries.

He says that professionals have the duty to advise patients about potential risks. “The patient must be aware that she is using a synthetic medical device, that there is a possibility of local changes in the implant itself, that it has to be periodically monitored, and eventually, like every surgery, there are risks.”

“IT WAS 4 YEARS OF LIFE LOST, 4 YEARS NOT LIVING. TODAY, I LIVE”

Suelen Ferreira, colorimetry specialist:

“I had silicone implants 6 years ago. It is every woman’s dream to have a beautiful ‘bust’. I was about to turn 30, I had several friends, colleagues, clients with silicone. The surgery was perfect, with no complications, I was very pleased. But the first symptoms began after 6 months and I didn’t know, nor imagined, that it could be the silicone.

“Muscle pain began, in the body, in the bones, which worsened in a surreal and absurd way. Four years ago my life stopped: I couldn’t work anymore, a simple walk in the mall left me breathless, tired, my upper and lower limbs swelled up. My vision became blurred.

“In the last 2 years I had my first prosthesis contracture and rotation. I felt excruciating pain in my chest. It got to the point where I couldn’t take a shower, couldn’t brush my teeth. I didn’t have any strength in my arm, I couldn’t hold a glass. I burned myself several times because I dropped things.

“I began researching on Instagram, Facebook, Google, until in January I found websites containing information about explantation. I had the surgery on July 30. I was able to breathe for the first time after the removal.

“No more fatigue, no more muscle pain. I went back to work. Occasionally my vision blurs, I experience conjunctivitis and tinnitus in my ears.

“Four years of life were lost, four years not living. Today I live. If I had known 6 years ago everything that is exposed today, if I had more access to certain information, I would have had the power to choose. This is my experience: I am not arguing against silicon, but of what it did to me.”