"He sold me a fairytale to fill his own pockets": The horror reality of botched breast implants.

Fatigue. Numbness. Cognitive impairment. 

It had been 13 months since Robyn Smith's preventative double mastectomy and breast reconstruction surgery, and she was now suffering from multiple chronic health conditions.

Her hair had started to fall out. She couldn't sleep. She was constantly nauseous. Her lymph nodes were swollen. Her hands and arms were numb and tingling.

She'd never felt worse.

Watch: NSW mother Kayla Cole tells 7.30 she regrets having breast implants. Post continues below.

Categorised as "high risk" after finding out she was a BRCA1 mutation carrier, Robyn had undergone a double mastectomy to prevent the possibility of breast cancer.

"In my life, I had never done something that I so strongly didn't want to do, but I had to because the odds of developing cancer were too high. I actually didn't consider it much of a choice. I had a skin-sparing prophylactic double mastectomy and reconstruction in February 2019," she said.

"I cried all the way into the operating theatre."

Listen: Everything to know about finding out you have the breast cancer gene. Post continues below.

At the advice of her surgeon, immediately after her mastectomy Robyn also underwent breast reconstruction surgery using silicone gel implants. 

"My surgeon said that women who woke up with some sort of breast did better mentally than those who didn't reconstruct," she shares.

"I wasn't a good candidate for other reconstruction options and I did not want to use my own muscle or tissue. 'Going flat' was glossed over, so I didn't really consider it. Admittedly, I was a bit blasé about it all and just did what the surgeon suggested because I didn't want poor mental health outcomes."

However, after undergoing her initial surgery, Robyn never fully recovered. In fact, she would go on to suffer countless debilitating symptoms over the next year - none of which she was warned about. 

She battled with constant fatigue and brain fog; she was forgetting things and finding it difficult to do normal everyday activities.

"I went to various doctors and my surgeon, who tested my autoimmune markers and ran various other bloods. My autoimmune marker rose quickly after about six months and eventually went as high as it is measured," Robyn shares.

"My hair was falling out and snapping off, my lymph glands were swollen, I developed insomnia, nausea, and eventually a bit of anxiety because of what was happening. I was diagnosed with two autoimmune diseases which I did not have before I got implants, and have since disappeared after explant." 

Robyn also experienced worsening Raynaud's syndrome. Her hands turned purple.

Image: Supplied

Eventually, she had her breast implants removed.

"After 13 months with implants, my health was so poor that I explanted to flat. I couldn't be happier and healthier."

The effects of the explant surgery were immediate.

"Within two weeks, the numbness and tingling in my hands and forearms resolved. My fatigue stopped within a month and I was back to exercising daily. I am so happy to be healthy and flat now."

"I was so unwell with implants and doctors kept treating my symptoms but weren't looking for a cause. I was 'tisk-tisked'' whenever I would dare suggest there was a link between silicone implants and my sudden health crisis."

"A rheumatologist told me how controversial it was to suggest such a thing. I am glad to see my symptoms improve and my health return after explanting. My blood work has improved which gives me confidence that I made the right decision."

While it's still not a medically diagnosed condition, there is a growing push for more research into Breast Implant Illness (BII) causes, symptoms and risk factors. 

"BII is definitely not spoken about by many surgeons," said Robyn. "I had a consult with a surgeon who said that BII was psychosomatic (in my head) and that there was no evidence for it, but then he went on to tell me that he'd done 60 to 70 explants, and 80 per cent of patients improved after explanting."

Sadly, stories like Robyn's aren't uncommon. In fact, they're more prevalent than ever before, with the rates of explant surgeries in Australia skyrocketing.

Take Simone Williams, for example.

She remembers scouring the web and doing hours and hours of research into elective breast surgery - reading reviews, looking at before and after pictures, and checking if surgeons were board-certified, before narrowing her selection down to three plastic surgeons. 

"I called the first surgeon (my preferred choice) for an appointment and was told there was a waitlist for months. The receptionist suggested I see another surgeon in the same rooms, as he could see me far sooner."

"I met the doctor, and he was very charming and sweet. He was also very persuasive. I had a list of questions in my hand and I was determined I would come away with all the answers to make an informed decision. After the initial chat, we got to business with the examination."

"He told me there was "no lift required" and we would just "put in bigger implants", assuring me it was a "relatively simple process". He had me sold, hook, line and sinker, and before I could bat an eyelid, [we] had a surgery date and my money paid."

"No questions, information, no time to think about anything... he had my money and made me feel very comfortable that it was going to be everything I wished for. He had sold me all I wanted."

Aside from what she had researched and learned herself on the internet, Simone cannot recall any discussion during the pre-surgery consult about potential health risks and complications associated with breast surgery.

"I was never once made aware or told about risks. I was just handed a brochure."

The surgery went ahead, and the first thing Simone noticed was 'the waterfall effect' - a sliding of the breast tissue over the implant.

"My skin and nipple looked like it was falling off my implant, but when I questioned it, the explanation was that it would subside and the implants would drop and fluff. I believed him."

As advised, Simone waited for the issue to resolve over the following weeks. However, upon her next visit to the surgeon, nothing had changed. 

"Apparently because I had not opted for a lift, this was my fault. However, he said there was another option - a 'half-moon lift'. He would cut a half-moon shape above my areola and suture it back together, and that would take up the excess skin and put my nipple back to where it should be at the front of my breast, not basically underneath."

"I scheduled for that appointment, and out to the back room I went. Again, I trusted him and had no idea of what was involved. He was a plastic surgeon after all - not just a cosmetic surgeon. Apparently, it was a simple procedure that took around 10 minutes and it would be fixed."

"A little local anaesthetic and he got to work. By the time it was over, my whole body was shaking in shock. I was stitched and taped and told to come back in 10 days."

After 10 days, the stitches were removed - although not much had changed. 

"I cried when I saw it. Another scar and no result. I was heartbroken. His exact words were: 'If you had paid for a lift it would be so much better, so this is what you get'. I was left to go on my way." 

Simone remembers sitting outside a shopping centre sobbing, feeling absolutely broken. 

"I cried so hard I couldn’t even walk to my car. I’d been abandoned by someone that was supposed to take care of me. A professional that was supposed to have my health, my safety, and best interests at heart."

"But I had a man with dollar signs in his eyes. He had sold me a fairytale to fill his own pockets. A man that calls himself and advertises on social media to this day as a “leading plastic surgeon”. 

The effect of the surgeries was dramatic, she said, and it took a large toll on her mental health.

"I suffered so badly. I had what I thought were deformed breasts. I had what he made me believe was abnormal, and it was my fault. That’s how he made me feel. I couldn’t mentally move past it. I looked and felt like the biggest fool. I’d cover up everything, I’d wear loose tops, and hope no one was looking at me. Every time I physically looked at my breasts, I would just break down and cry for hours. I got to the point where I wouldn’t go out some days."

Simone underwent surgery to remove her breast implants, and a definite lift was required.

A rise in breast implant removals.

In Australia, an estimated 20,000 women undergo breast augmentation surgery annually (according to the Australian Breast Device Registry report). In most cases, it's undertaken for reconstructive and cosmetic purposes.

However, despite the high numbers, Robyn and Simone are part of the growing number of Australian women who are choosing to have their breast implants removed. 

The rates of explant in Australia from 2016 to 2020 have risen dramatically.

The ABDR report shows that despite the effects of the pandemic, the explant rate rose from one per cent to four per cent (for recon patients) and one per cent to seven per cent (for augmentation patients) in 2020.

Sydney-based plastic and reconstructive surgeon Anand Deva said, "I am seeing an increasing number of women who have had poor outcomes following the use of breast implants both for cosmetic enhancement and reconstruction after breast cancer."

"Many of these women were not fully informed of the risks of these devices prior to agreeing to undergo surgery," said Professor Deva.

Such is the case for patients like Robyn, who said the full risks and complications of breast implants were glossed over by her surgeon.

"She [the surgeon] said, "These are not lifetime devices and your biggest worry is a rupture or capsular contracture but these risks are low". That was it. There is a bunch of information on the FDA website that clearly outlines the many risks and complications of implants but I was not told half of it."

"I was also not told about future screening requirements (i.e. patients should have an MRI or implant check every two to three years). I should have looked all of this up before my surgery and I own that, but it would be handy if my treating doctors mentioned these things to me before my major surgery. In hindsight, I really didn't make an informed decision."

Professor Deva said he sees the impact of this lack of care on a weekly basis, with rising numbers of patients coming to him for explant surgery.

"We perform between three to five implant removals a week across our two centres in Sydney. It is interesting to note that for the first time the number of implants going in has fallen, whilst there has been a significant increase in the number of implant removal worldwide," he said.

"It's important that women understand that these devices are not lifetime devices. It is a 100 per cent certainty that they are signing up for future surgeries to both implants and their breasts."

The new guidelines for breast implants.

NSW Health has recently released a comprehensive set of guidelines outlining what is expected of medical practitioners, as well as what patients need to know before their first consultation.

The guidelines outline a minimum of two in-person consultations with patients before surgery, along with pre- and post-operation ultrasounds and mammograms, cooling-off periods, reporting of implants, and adverse events into the Australian Breast Device Registry, as well as ongoing surveillance of breast implants after surgery.

Professor Deva, who is the co-author of these guidelines, said, "These guidelines provide a clear framework for both doctors who use breast implants and women who are considering them for both cosmetic enhancement and reconstruction."

"They were developed in response to the worldwide regulatory action in 2019, which saw a number of highly textured breast implants removed from the market due to safety concerns. It sets the standard in NSW for the best care of patients who are considering breast implants or wish to have their breast implants removed," he said.

Robyn said, "There are so many positives to these new guidelines. Above all, they will protect patients and support patients to make informed decisions. They ensure that patients have greater opportunity to ask questions and really understand procedures and options."

"The guidelines will create better outcomes for patients in an industry that is questionably regulated. The focus is about educating and involving patients rather than telling them what is going to happen," she adds.

After a recent Four Corners investigation on ABC sparked widespread concerns over botched surgeries, patient safety and hygiene breaches in the aesthetic industry, the Australian Health Practitioner Regulation Agency (AHPRA) also launched an external review of the cosmetic sector.

According to Professor Deva, there are still some core issues that need to be addressed to achieve meaningful change in the cosmetic industry, including a bigger push for informed, educated consent.

He also said there needs to be a change in the lack of transparency around qualifications, outlining the need for credentialing and titling to ensure that doctors performing cosmetic procedures are adequately trained and certified. 

Right now, anyone with a medical degree can call themselves a cosmetic surgeon.

Professor Deva also stresses the need for changes around advertising, including "restrictions on the use of influencer marketing, sexualised imagery, false claims, and the use of gifts or incentives to lure unsuspecting and vulnerable patients."

Along with this, he said there needs to be a bigger focus on duty of care and reporting of any complications.

Professor Deva concludes: "In the end, it is all about empowerment and respect for patients. The choice and power of an informed and educated patient will ultimately drive better standards of care and call poor practice and practitioners to account."

"Cosmetic practice needs to move in from the fringes, and become more in line with the way the rest of medicine is practiced, i.e. evidence-based, patient-focused... and away from the commercial drivers that seek to generate profits by preying on vulnerable and unsuspecting patients."

You can follow this link to help Professor Deva's Macquarie University study.

Feature image: Canva; Mamamia.