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Implant fill: ☐ Silicone ☐ Saline ☐ Both Implant Shape: ☐ Round ☐ Shaped Implant surface: ☐ Smooth ☐ Textured Implant placement: ☐ IMF ☐ Axilla ☐ Areola ☐ Umbilicus ☐ Mastectomy Incision Were you happy with your initial implant placement? Yes ☐ No ☐ If not, please explain
25 sie 2020 · Breast Implant Illness (BII) is a term used by women with breast implants who describe a variety of symptoms including (but not limited to) fatigue, chest pain, hair loss, headaches, chills, photosensitivity, chronic pain, rash, body odor,
3 | P a g e How long after implant placement did your symptoms begin? Please check if you have any of the diagnoses below: ☐ Fibromyalgia ☐ Hashimoto’s Thyroiditis ☐ Irritable Bowel Disease ☐ Endocrine Dysfunction ☐ Graves’ Disease ☐ Inflammatory Bowel Disease ☐ Hypothyroidism ☐ Lyme Disease ☐ Vitamin D deficiency ☐ Other: Did you have any of the above symptoms or ...
Breast Implant Patient Decision Checklist Example. As of November 27, 2021, the FDA requires all breast implant manufacturers to include a device-specific Patient Decision Checklist with information on known or reported risks of breast implants. Your board-certified plastic surgeon will provide a checklist from the manufacturer that is specific ...
Breast Implant Illness (BII) is a term used by women who have breast implants and who self- identify and describe a variety of symptoms including (but not limited to) fatigue, chest pain, hair loss, headaches, chills, photosensitivity, chronic pain, rash, body odor, anxiety, brain fog, sleep
Breast Implant Illness is a condition that consists of a very broad range of non-specific symptoms such as hair loss, brain fog, general fatigue, fibromyalgia and other associated conditions such as ME, irritable bowel syndrome, various skin conditions and autoimmune conditions such as lupus, rheumatoid, SLE and Raynaud’s.
Prospective Study on Breast Implant Illness . Patient follow-up questionnaire ☐3 months ☐ 6 months ☐ 12 months ☐ 18 months ☐ 2 years. March 2021 V 5.0 . 2. FORM 3: BII Symptom tracker SPN: _____ Please list your symptoms and date of onset
