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The Great Un-Augmenting of America’s Boobs

Citing changing beauty standards and the symptoms of a mysterious illness, women are clamoring to get their implants out, stat

Big naturals are more than just a body part. They’re an energy, a culture, a lens through which we consume and create the world around us. And while big-breastedness may be both spiritual and bodily, there is a material world and timeline of events that document how this culture came to be. As MEL’s resident boob culture writer and a woman of breast-experience, I’ll be analyzing these objects and happenings, telling the stories of their origins and their impact on society. This is Big Moments in Big Naturals.

In 2014, model Sara X Mills went viral on YouTube for “twerking” her DD boobs to the rhythm of Mozart’s “Eine kleine Nachtmusik.” The since-deleted video amassed more than 40 million views on YouTube and brought her to the attention of America’s Got Talent, leveraging her internet fame into nationwide popularity all thanks to her breast implants. Then, in 2016, she did the unthinkable: She got them taken out. 

There’s something shifting in the world of breasts. Breast augmentations are down 33 percent from 2019 to 2020, according to the American Society of Plastic Surgeons. This would mean nothing in light of the pandemic, considering nearly every single cosmetic surgery experienced a similar decline — except, that is, four of the 28 tracked in the American Society of Plastic Surgeons’ annual statistics report. Two of those, as you might expect, were Brazilian butt lift-related. A third was pectoral implants, a procedure that remains niche — at less than 700 cases per year, it’s hardly worth counting. The fourth, however, was breast implant removals, which increased by eight percent from 33,642 instances in 2019 to 36,367 in 2020. 

The narrative that breast implant removals are on the rise has proliferated, too. The New York Times reported on it in October 2021, Healthline in November, Women’s Health in December and The Sun and Daily Mail today, as it just so happens. Some celebrities who have recently discussed their removals include Chrissy Teigan, Ayesha Curry, Ashley Tisdale and Tori Spelling. Michelle Visage of RuPaul’s Drag Race even catalogued her implant removal for the Paramount+ documentary Explant in December. Plenty of other famous women got them removed around the same time as Mills, if not decades prior — even Pamela Anderson got hers out in 1999. All these recent stories have a common through-line — something called “breast implant illness,” or BII. 

“There’s been a lot more talk about breast implant illness, which is really an ill-defined thing we don’t have our finger on yet,” says Jordan Frey, a plastic surgeon specializing in breast reconstructive surgery in Buffalo, New York. “It’s a constellation of symptoms that some people experience with implants. It’s difficult for us to say whether the implants cause it or not, but regardless, a lot of these patients come in and want the implants out, if only to eliminate that as a variable.”

Per Google Trends, discussions of BII began picking up in 2016 and have peaked in the last two years. Prior to that, such a term didn’t exist. Some of the symptoms include fatigue, migraines and pain in the breasts and elsewhere. Other people report endocrine issues, neurological decline, the formation of new allergies and gastrointestinal problems. 

Unfortunately, there has yet to be any concrete studies to solidify the existence of BII, with the exception of a rare form of cancer called breast implant-associated anaplastic large cell lymphoma. Last fall, the Food and Drug Administration ramped up their restrictions of implants, adding further requirements for surgeons to properly disclose risks with patients prior to surgery as a result of this cancer. As of October 2019, 809 cases were reported worldwide, and 33 patients had died. The majority of cases were associated with a specific type of “textured” implant manufactured by Allergan, which has since been recalled. (According to Frey, “smooth” implants don’t carry the same risks.)

But none of the more famous examples of women getting their implants removed cite this cancer as the cause. Instead, it’s often because they’re experiencing mystery symptoms under the umbrella of BII. Crystal Hefner, for example, wrote in a Facebook post that she had “intolerance to foods and beverages, unexplained back pain, constant neck and shoulder pain, cognitive dysfunction (brain fog, memory loss), stunted hair growth, incapacitating fatigue, burning bladder pain, low immunity, recurring infections and problems with my thyroid and adrenals.”

It’s also become a common topic for YouTubers. “I experienced breast pain, back pain and toward the end, symptoms of hypothyroidism,” beauty YouTuber Sacheu says in a 2019 video about her implant removal. “The thing that stood out the most was dry skin. I started looking it up, and those are symptoms of breast implant illness. I don’t want to say I have it, because it’s not even a recognized illness.” 

Another YouTuber, Karissa Pukas, shared that she believes her implants made her depressed and caused her to develop a “really nasty body odor… a metallic acidic stank.” The video now has 1.8 million views

Again, there’s no clinical evidence for the existence of BII, which makes this all the more mysterious. “There have been a lot of studies that have looked at breast implants and these symptoms, and the real answer that’s come out is, no, it’s not associated with things like fibromyalgia or connective tissue disorders,” says Frey. “Even studies looking at silicone and the amount that leaks out of implants and into tissue found that it’s a minuscule amount. It’s not something that’s worrisome from a health standpoint.”

This isn’t to discount the reality of what women are experiencing — if anything, it only furthers how deeply frustrating and scary it can be. “These patients are feeling something very real,” says Frey. And so, when someone suspects their implants are making them sick, the natural conclusion is to remove them. “Usually the discussion I have with patients is that they’re experiencing these symptoms and I can’t exactly say why, but we can certainly remove the implants, eliminate that variable and hopefully they get better.”

By most accounts, they do improve. Both Sacheu and Pukas say they felt better afterwards, as have numerous celebrities who have gotten theirs removed, too. Hefner said she felt better almost “instantaneously” after her explant. As for Mills, “I actually like how I look better now,” she said in a video explaining her surgery. “I took them out, and I have felt better since the entire time I took them out. So there’s something there. I do not regret taking them out whatsoever.”

Of course, a much less serious but still notable undercurrent to this shift is changing aesthetics. In Frey’s experience, there’s been an increased interest in removal among restorative breast surgery patients who want a more “natural” look, and further among patients who have received mastectomies opting to skip the implants entirely. Nevertheless, breast augmentations do remain one of the most popular cosmetic surgeries in the country, despite that dip between 2019 and 2020. And aesthetics and illness aside, at least some of those removal stats are chalked up to the fact that implants are only meant to last around 10 years before needing to be replaced, anyway. 

What all of this highlights, though, are the risks and pain people will endure in order to achieve a certain breast ideal. Having big boobs can afford a person a lot of fame and fortune. “They made me a lot of money, I got to travel the world,” Mills says of her implants in her YouTube video. The same for Dolly Parton and Anna Nicole Smith, whose breasts elevated their entire profile. But for some women, a vague, often debilitating illness comes with it, and that’s no longer a trade they’re willing to make.