BACKGROUND: Explantation of breast implants is increasingly performed in response to concerns about Breast Implant Illness (BII), an array of various health symptoms. However, the benefits of explantation remain unclear due to methodological limitations in prior studies. OBJECTIVES: To examine the occurrence of health symptoms before and after explantation of cosmetic breast implants. METHODS: Retrospective cohort study linking data from the Dutch Breast Implant Registry and Nivel Primary Care Database. The study included 217 cosmetic explantation patients, and control groups of 228 cosmetic replacement patients, and 433 women without breast implants (non-recipients). BII-related health symptoms presented in general practice were compared between groups one year before and after explantation. Outcomes included any symptom, ≥2 symptoms, ≥3 symptoms, ≥3 consultations, and substantial symptoms (≥3 symptoms with ≥2 consultations for two symptoms). RESULTS: The likelihood of ≥3 symptoms, ≥3 consultations, and substantial symptoms reduced significantly after explantation (OR ≥3 symptoms 0.26, 95% CI [0.08-0.85]
OR ≥3 consultations 0.56, 95% CI [0.32-0.96]
OR substantial symptoms 0.36, 95% CI [0.14-0.94]). However, compared to non-recipients, explantation patients still had higher odds of any symptom, ≥2 symptoms and ≥3 consultations after explantation. Replacement patients also had a reduced likelihood of any symptom, ≥2 symptoms, and ≥3 consultations from pre- to post-surgery. CONCLUSIONS: Although explantation appears to improve BII-related health symptoms within a year, women still showed an increased likelihood of symptoms compared to non-recipients.