Clinical Management of Breast Implant Illness and Breast Implant-Associated Somatic Symptom Disorder (BIA-SSD): Case Examples of Treatment Options.

Patients presenting with systemic symptoms associated with breast implants often exhibit heightened anxiety and may meet diagnostic criteria for breast implant-associated somatic symptom disorder (BIA-SSD). BIA-SSD is characterized by persistent anxiety and preoccupation with systemic symptoms that interfere with daily functioning for 6 months or longer. Recent research has clarified diagnostic strategies and treatment approaches for somatic symptom disorders. This report presents 2 cases illustrating both nonsurgical and surgical management of patients meeting criteria for BIA-SSD. Both patients underwent comprehensive medical evaluations, including clinical examination and breast magnetic resonance imaging, which were negative for underlying medical pathology. Nonsurgical treatment, including detailed counseling by the plastic surgeon and referral for cognitive behavioral therapy with a qualified therapist, was offered to the patient who wished to retain her implants and was receptive to psychological care. For the patient who declined therapy, surgical management including explantation and simple capsulectomy was performed. Both patients experienced significant improvement in anxiety and somatic symptoms, despite pursuing different treatment pathways for BIA-SSD.