Bresnick Stephen D, Faasse Kate, McGuire Patricia
From the Private Practice, Los Angeles, CA.
Private Practice, Plastic Surgery, School of Psychology, UNSW Sydney, Australia.
Plast Reconstr Surg Glob Open. 2025 May 1;13(5):e6735. doi: 10.1097/GOX.0000000000006735. eCollection 2025 May.
Psychological factors seem to play a significant role in the perception and magnification of somatic symptoms in patients with breast implant illness (BII). Further, recent studies have shown that some patients with self-reported BII have findings consistent with a breast implant-associated somatic symptom disorder (BIA-SSD). The aim of this work was to provide guidelines for the diagnosis and treatment of BIA-SSD.
Findings from the current literature combined with both surgical and psychological therapeutic principles were used to develop methods for diagnosing and managing patients with BIA-SSD.
Algorithms for the diagnosis of SSD associated with breast implants, as well as treatment options, are presented so that plastic surgeons can identify, counsel, diagnose, and offer treatment to patients with BII and findings consistent with BIA-SSD.
Plastic surgeons are in a unique position to identify self-reported BII patients with signs of BIA-SSD and offer help in navigating treatment options. In addition to providing information to patients about somatic symptoms and breast implants, surgeons should refer patients for a medical workup to rule out medical causes of symptoms. For patients with symptoms and a desire to maintain breast implants, referral to a qualified mental health professional trained in SSD therapy may be beneficial. For patients desiring removal of their implants for BII symptoms, explantation with the most conservative possible procedure is recommended.
心理因素似乎在乳房植入物疾病（BII）患者对躯体症状的感知和放大过程中发挥着重要作用。此外，最近的研究表明，一些自我报告患有BII的患者的检查结果与乳房植入物相关的躯体症状障碍（BIA - SSD）相符。这项工作的目的是为BIA - SSD的诊断和治疗提供指导方针。
结合当前文献的研究结果以及手术和心理治疗原则，制定诊断和管理BIA - SSD患者的方法。
本文介绍了与乳房植入物相关的躯体症状障碍的诊断算法以及治疗方案，以便整形外科医生能够识别、咨询、诊断患有BII且检查结果与BIA - SSD相符的患者，并为其提供治疗。
整形外科医生处于独特的地位，能够识别自我报告患有BII且有BIA - SSD迹象的患者，并在指导治疗方案方面提供帮助。除了向患者提供有关躯体症状和乳房植入物的信息外，外科医生应将患者转诊进行医学检查，以排除症状的医学原因。对于有症状且希望保留乳房植入物的患者，转诊给接受过躯体症状障碍治疗培训的合格心理健康专业人员可能会有所帮助。对于因BII症状而希望取出植入物的患者，建议采用尽可能保守的手术进行取出。
