COVID-19 Infection and Vaccination Effects on Breast Implant Illness: A Case Report

Breast implant illness (BII) is a term used to describe a range of symptoms associated with silicone breast implants. This condition suggests that silicone may trigger symptoms in individuals who are immunologically predisposed, and the spectrum of symptoms may be linked to autonomic dysregulation in these patients. We present the case of a female patient in her mid-40s with a history of autoimmune thyroiditis who had not required prior therapy. She underwent breast augmentation and subsequently developed gradual difficulties. After recovering from a COVID-19 infection, her nonspecific symptoms, consistent with BII, worsened. These symptoms included chronic fatigue, hair loss, dry skin, petechiae, low-grade fever, and frequent urination. Additionally, she developed symptoms associated with long COVID. A subsequent Pfizer-BioNTech COVID-19 vaccination further exacerbated her symptoms and overall condition. Due to the broad spectrum of nonspecific symptoms, the patient underwent numerous screenings over an 18-month period, which were inconclusive. We hypothesize that the vaccination and previous infection had a synergistic effect on her ongoing BII symptoms, contributing to the worsening of her condition. An isolated right-sided seroma with left-sided lymphadenopathy appeared to be a side effect of the vaccine. Additionally, the patient developed a newly diagnosed allergy to polyethylene glycol and other allergic manifestations, such as chronic urticaria, which are consistent with autonomic nervous system dysregulation and long COVID. These symptoms resolved within three weeks of explantation with en bloc capsulectomy. It is noteworthy that the patient was unaware of BII until an MRI revealed a suspected intracapsular implant rupture on the right side, which led to the decision to remove the implants.