Can You Get Breast Implants with Ehlers-Danlos Syndrome?

Ehlers-Danlos syndrome (EDS), particularly its hypermobile form (hEDS), presents unique challenges when considering any surgery, including breast implants. With its impact on collagen, connective tissue, and healing, many patients wonder: Can you safely get breast implants if you have EDS? While the answer is nuanced, emerging evidence suggests that breast surgery, including implants, is not off-limits. However, there are special considerations that must be addressed to ensure safety and optimal outcomes.

Understanding Ehlers-Danlos Syndrome and Breast Augmentation Risks

EDS is a group of connective tissue disorders caused by genetic mutations that affect collagen, a vital protein responsible for maintaining the structure and integrity of tissues. The hypermobile type (hEDS) is the most common form and is marked by joint hypermobility, stretchy skin, and fragile tissues. These characteristics lead to frequent joint dislocations, chronic pain, and poor wound healing, all of which can complicate surgical procedures​​.

For patients with hEDS, the idea of elective surgery, such as breast augmentation, often raises concerns among both patients and surgeons. The risks associated with fragile tissues, bleeding, and slow wound healing make some hesitant to pursue surgery. However, recent studies are beginning to change the narrative, showing that with proper care and planning, surgery can be a safe option for individuals with EDS​​.

Breast Surgery and Ehlers-Danlos Syndrome: What the Research Says

In the past, many surgeons were reluctant to operate on patients with EDS due to concerns over potential complications. Issues like wound healing problems, excessive bleeding, and tissue fragility were often considered too risky for elective procedures like breast augmentation. However, a recent case series published in the Journal of Plastic, Reconstructive & Aesthetic Surgery challenges this idea, reporting successful outcomes in patients with hEDS who underwent breast surgery​.

In this study, four women with hEDS, aged 18 to 42, underwent breast surgeries, including breast lifts (mastopexy) and breast reduction. Despite the inherent risks, all patients experienced positive outcomes with no major complications. One patient did experience a "spitting suture," a common minor complication where the body rejects a suture, but this was managed without long-term issues​.

What’s important to note is that the benefits of surgery—such as relief from macromastia-related pain (pain caused by large breasts)—often outweigh the potential risks, particularly when it comes to quality of life improvements. In fact, all the women in the study reported significant pain relief in their neck, back, and shoulders following surgery, with continued improvement throughout their recovery period​.

Risks of Breast Implants in EDS Patients

While the case study focuses on breast lifts and reductions, it also offers valuable insights for those considering breast implants. One major concern with breast implants in EDS patients is the risk of capsular contracture, where scar tissue forms tightly around the implant, potentially causing pain and deformity. This can be particularly problematic for individuals with connective tissue disorders like EDS, where tissue healing is already compromised​​.

Additionally, the fragility of skin and underlying tissues in EDS patients makes them more prone to complications like wound dehiscence (where a wound reopens) or delayed healing. For this reason, it’s critical for surgeons to tailor their approach to the specific needs of EDS patients, using meticulous surgical techniques and careful postoperative monitoring​​.

Silicone and Mast Cell Activation: A Potential Concern

One consideration unique to EDS patients is the potential overlap with Mast Cell Activation Syndrome (MCAS). MCAS is a condition often seen in people with EDS, where mast cells in the body release too many inflammatory substances, leading to a range of symptoms, including allergic reactions and chronic inflammation. Breast implants, especially silicone-based ones, have been known to trigger immune responses, potentially worsening MCAS symptoms​​. Although Breast Implant Illness has been dismissed by most of the medical establishment, the federal government and celebrities have reported a very large number of cases of breast implant illness.

In patients with both MCAS and EDS, implants may provoke an overreaction of the immune system, causing symptoms that mimic or worsen Breast Implant Illness (BII). Therefore, it’s important to discuss these risks with a knowledgeable surgeon who can help weigh the benefits and risks specific to your situation​​.

Is Surgery Safe for EDS Patients?

The answer is yes, with caveats. While EDS poses unique risks for any surgery, including breast implants, these risks can often be mitigated with careful planning and the expertise of a surgeon familiar with connective tissue disorders. As seen in the study of women who underwent breast lifts and reductions, many EDS patients can experience successful outcomes with minimal complications​​.

However, it’s crucial that patients with EDS considering breast implants work closely with a medical team experienced in both connective tissue disorders and plastic surgery. Preoperative consultations should include thorough discussions about the risks of delayed wound healing, capsular contracture, and potential immune reactions​​.

What to Expect After Surgery

For EDS patients undergoing breast augmentation, recovery can be more complex than for those without the disorder. EDS can cause delayed wound healing, so it’s essential to follow your surgeon’s postoperative care instructions carefully. Your surgeon may recommend longer follow-up periods to monitor for complications such as scarring or capsular contracture​​.

Additionally, if you have MCAS, you may need to manage inflammation or allergic reactions more aggressively after surgery. Some patients may benefit from medications that stabilize mast cell activity to prevent flare-ups​​.

Conclusion: A Careful Approach to Breast Implants in EDS

For women with Ehlers-Danlos syndrome, breast implants are not out of the question, but they do require special considerations. While EDS presents risks such as fragile tissues and slow healing, emerging evidence shows that successful surgery is possible with the right precautions. By working with a skilled surgical team familiar with the nuances of EDS and MCAS, patients can achieve good outcomes and improve their quality of life.

Ultimately, the decision to get breast implants should be made carefully, taking into account both the risks and the potential benefits. With proper planning and an informed approach, women with EDS can safely pursue breast surgery if they choose.

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FAQs About Breast Implants and Ehlers-Danlos Syndrome (EDS)

Can you get breast implants with Ehlers-Danlos syndrome?‍

Yes, individuals with Ehlers-Danlos syndrome (EDS) can get breast implants, but it comes with additional risks. Due to connective tissue fragility, there is a higher likelihood of complications like poor wound healing, capsular contracture (scarring around the implant), and prolonged recovery. However, with proper planning and care from a surgeon experienced with EDS patients, breast implants may still be a viable option.

How does EDS affect the breasts?‍

EDS, particularly the hypermobile type (hEDS), affects collagen and connective tissue, which can cause skin laxity, stretchiness, and drooping breasts (ptosis). Additionally, individuals with EDS may experience greater discomfort from larger breasts due to neck, shoulder, and back pain, making breast reduction surgery a common consideration​​.

What syndrome is associated with breast implants?‍

Breast Implant Illness (BII) is a term used to describe a wide range of symptoms some women report after getting breast implants. These symptoms can include chronic fatigue, joint pain, brain fog, and autoimmune-like reactions. Some research also suggests a potential link between breast implants and Mast Cell Activation Syndrome (MCAS) in certain individuals​​.

Can people with EDS have plastic surgery?‍

Yes, people with EDS can undergo plastic surgery, but special precautions are necessary. Tissue fragility and healing challenges make it important for surgeons to tailor their approach to minimize complications. Recent studies have shown that patients with EDS can have successful outcomes with surgeries like breast reduction or lift, provided the surgeon is experienced in treating connective tissue disorders​​.

What disqualifies you from getting breast implants?‍

Several factors could disqualify someone from getting breast implants, including:

• Chronic or uncontrolled illnesses like diabetes or heart disease.
• Poor wound healing or history of surgical complications (more common in conditions like EDS).
• Psychological concerns that affect body image or expectations about the surgery.
• Autoimmune conditions or chronic inflammation that may be aggravated by implants​​.

Can breast implants trigger autoimmune diseases?‍

Yes, breast implants have been associated with triggering or exacerbating autoimmune-like symptoms in some individuals, a condition often referred to as Breast Implant Illness (BII). Research suggests that silicone or other implant materials may provoke an immune response, particularly in individuals who are already predisposed to autoimmune conditions​​.

Who is more prone to breast implant illness?‍

Certain groups may be at a higher risk for Breast Implant Illness (BII), especially:

• Individuals with a personal or family history of autoimmune diseases.
• Those with chronic conditions like fibromyalgia, MCAS, or EDS.
• People with multiple allergies or heightened immune responses​​​.

For people who fit these criteria, it is important to discuss risks thoroughly with a surgeon before deciding on breast implants.

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References

1. Morris, B. E., Ishimoto, A. K., Casey, W. J., Rebecca, A. M., & Kurnik, N. M. (2024). "Breast surgery in patients with hypermobile Ehlers-Danlos syndrome." Journal of Plastic, Reconstructive & Aesthetic Surgery, 88:109-111.
2. Nagy, È. S., et al. (2024). "Breast Implant Illness May Be Rooted in Mast Cell Activation: A Case-Controlled Retrospective Analysis." Annals of Surgery Open, doi:10.1097/AS9.0000000000000398​.
3. Seneviratne, S. L., Maitland, A., & Afrin, L. (2017). "Mast Cell Disorders in Ehlers–Danlos Syndrome." American Journal of Medical Genetics Part C 175C:226–236​.
4. Mitakides, J., & Tinkle, B. T. (2017). "Oral and Mandibular Manifestations in the Ehlers–Danlos Syndromes." American Journal of Medical Genetics Part C 175C:220–225​.
5. Padmanabhan, J., et al. (2022). "Two Independent Capsules Surrounding a Single Textured Implant in Ehlers-Danlos Syndrome." Plastic and Reconstructive Surgery Global Open, doi:10.1097/GOX.0000000000004470​.
6. Miller, C. S., et al. (2021). "Mast Cell Activation May Explain Many Cases of Chemical Intolerance." Environmental Sciences Europe, 33:129​.

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