Women should be warned about breast implant illness.

Women having breast implants should be warned about a condition linked to chronic pain and extreme fatigue, the British Association of Aesthetic Plastic Surgeons (BAAPS) has said.

Tens of thousands of women on online forums claim they have suffered breast implant illness (BII), of which there is little scientific evidence but surgeons, including from BAAPS, are now calling for more research.

Breast implant illness is not an official diagnosis, but some women who believe they have it, say they returned to full health after having their implants removed.

The MHRA says there has been more than one million breast implant operations in the UK. Surgeons say most patients are happy with the results but a number of women have said that they experienced complications that they had not been warned about.

Fitness instructor Naomi Macarthur, 28, from Brighton, decided to get breast implants in 2014, but within weeks began to suffer "the most horrific symptoms.”

Ms Macarthur, who experienced a long list of symptoms including hair loss, allergies and rashes, said: "I remember getting severe pain in my stomach and the tiredness was like I had run a marathon and dug a million trenches and I hadn't done anything. Writing with a pen was too tiring."

She said doctors repeatedly told her the illness was unrelated to the implants, and at one stage diagnosed her with lupus.

Then, last year, she discovered breast implant illness and found online support groups.

She decided to have her implants removed, and within days the symptoms, which had affected her for four years, began to disappear.

She said: "I can't believe how amazing I feel, and how I have bounced back."

In parts of the medical community there remains scepticism towards breast implant illness. One surgeon said he did not believe it was a real condition.

Symptoms reported by those who say they have the illness, mainly related to the immune system, are broad and include fatigue, chest pain, hair loss, headaches, chills, photosensitivity, chronic pain, brain fog and sleep disturbance, all of which has meant there is currently little evidence that such issues are linked specifically to the implants.

The UK's National Secretary for the International Society of Plastic Surgery, Naveen Cavale, said: "As far as some of my patients are concerned, breast implant illness is very real, and I have no reason to doubt them. But, to me, as a doctor, it makes no scientific sense.

“Breast implant illness isn't something we used to talk about but the proper plastic surgery associations such as ourselves, have started advising we do so, which is a good thing to help patients to make more informed decisions."

Consultant plastic surgeon of BAAPS, Nora Nugent, agreed: "Surgeons should be warning patients about breast implant illness. Patients need the most up-to-date information possible, with the caveat that breast implant illness is poorly understood. So it's going to be difficult to give absolute information."

In the US, drugs regulation body, the Food and Drug Administration (FDA) has begun to investigate breast implant illness.

Hundreds of thousands of women were affected by the PIP breast implant scandal that broke in 2010.

The implants were twice as likely to rupture and were filled with silicone used in mattresses.

In 2016, a national safety implant register was set up, and women were encouraged to join it so they could be traced if something were to go wrong.

It is hoped the Breast and Cosmetic Implant Register, which covers implant procedures in England and Wales, will also lead to a better understanding of breast implant illness.

The Medicines and Healthcare products Regulatory Agency (MHRA) received 1,586 Adverse Incident Reports for breast implants between 2014 and May 2019 but breast implant illness is still not officially recognised.

Patients are calling for the MHRA's Yellow Card reporting system to be made more accessible, so the true scale of implant complications is known.

It said in a statement that "patient safety is our highest priority and we always investigate where there are safety concerns raised about a medical device".

It added: "We continue to work with European and international regulators, breast implant registries and experts to monitor issues and will take appropriate safety action where necessary."