Kiwi women are joining a growing international trend of having cosmetic surgery reversed due to severe illness and fears for their long-term health. Amy Wiggins and Ricardo Simich explore the world of implant reversals — including talking to one woman who says she felt like she was "going to die" due to side effects.
"I literally felt like I was dying."
Michaiah Simmons-Villari's health spiralled down in the years after she had breast implants at age 22.
At first she put it down to post-traumatic stress following the death of her partner, but when things were continuing to go downhill five years later, she knew there was more to it.
She was diagnosed with auto-immune disease and, while researching it, came across an article about breast implant illness.
That's when she knew they had to go.
Simmons-Villari, founder of Deluxe Events, is among a growing number of women having their silicone breast implants removed after suffering side effects they never expected.
She is part of an international trend in women seeking the reversal of cosmetic surgery procedures made popular by the likes of the Kardashians.
Nicola Robinson Evans, formerly Nicky Watson, has also made the call to have her breast implants removed, while last month Kylie Jenner spoke out about her decision to get rid of her lip filler.
Simmons-Villari, 31, says she had tried everything and was "almost bed-ridden" by the time she first heard about breast implant illness.
"I was constantly fatigued, constantly dizzy, had a foggy brain, no energy, to do anything was exhausting. I literally felt like I was going to die.
"I was living such a clean, healthy lifestyle. I didn't know what to do. It was really disheartening."
When she came across the article about breast implant illness she immediately knew that was the problem.
"I had 38 of those symptoms. I called my surgeon that day and said I want to have surgery. I want to take my implants out. Within two weeks I had the surgery."
Immediately afterwards she noticed the difference.
As soon as she woke up she realised she was seeing colours more vividly, in the next few weeks she lost 4kg and almost two years later she says she is 80 per cent better – although she believes she is still not rid of all the toxins from the implants.
"I can go on living my life. I've got my personality back, I can work long hours, I can go out and catch up with friends," she says.
Robinson Evans has also spoken out about her decision to have her breast implants removed after suffering from "breast implant illness".
"Gosh, when I do think of how they used to look, the word ridiculous comes to mind," she told Channel Seven's Sunday Night programme.
"I didn't actually like them. I didn't like how they felt, I didn't like how they looked, they just weren't me. And obviously I know 100 per cent too that they were making me sick and essentially ageing me, so it just made perfect sense to me that they had to go."
Robinson Evans said her mind was clearer and her body healthier since they were removed last May.
While the implants weren't ruptured, the scar tissue around them was "riddled" with silicone, she said.
"Which proved that even though the implants hadn't ruptured at all, the silicon was still leaching into my body."
Last month Kylie Jenner gave up her signature pout telling one of her 111 million Instagram followers: "I got rid of all my filler."
The Keeping Up with the Kardashian's star first admitted to having injections of hyaluronic acid into her lips in 2015, when she was just 17.
Her enhanced look became a social media phenomenon and the key to the success of her lip-focused cosmetics company, estimated to be worth a staggering NZ$1.32 billion, which has since triggered a tsunami of copycats.
Jenner's look was achieved with injections of fillers made of a lab-grown version of hyaluronic acid. Though it only lasts between three and 18 months, it seems Jenner had her fillers dissolved.
The number of patients wanting this kind of reversal has more than doubled in the past three years, according to Harley Street cosmetic doctor Tatiana Lapa, who says most patients seek a reduction in lip and puffy undereye fillers.
And Jenner is not the only global celebrity reversing her cosmetic procedures as fashion embraces a more natural aesthetic.
Last year, actress Courteney Cox said she'd had all her facial fillers dissolved, while Victoria Beckham, who had her breast implants removed in 2014, wrote a letter to her younger self in Vogue with some sage words: "Don't mess with your boobs."
Auckland plastic surgeon Dr Julian Lofts says more women are becoming aware of the possibility of silicone poisoning or breast implant associated-anaplastic large cell lymphoma and are choosing to have their implants removed as a precaution.
"There's more information available, on social media in particular, that is linking people up with other patients who have had symptoms related to silicone gel breast implants and they identify with that and then choose to have them removed – that is definitely increasing," Lofts says.
More information has come to light about breast implant associated-anaplastic large cell lymphoma in the past decade with recent research suggesting the risk of developing it is as high as 1 in 4000.
The disease is thought to be a result of inflammation caused by the implant surface and large amounts of bacteria living on the implant, he says. To combat the inflammation the immune system attacks the foreign proteins, becomes over-stimulated and develops into cancerous cells.
Lofts says people are increasingly being proactive and choosing to have their implants removed before it develops.
There is no evidence to suggest a direct link between symptoms reported by women, including joint pains, rashes, chronic fatigue and night sweats, and the implants, he says, "but, a lot of the women who do go on to have their implants removed, they do say how they do feel better".
But reversing the procedure doesn't solve everything.
"The silicone does get into the system - it gets into the lymph nodes," Lofts says. "Even though we're removing the implant we haven't necessarily removed all of the silicone from the system. The fine molecules of the silicone will even go through an intact implant and end up outside the breast."
Even so, Lofts still sees about 200 women wanting breast augmentations each year and about 100 women go through with them.
He says most women suffer no ill effects, although he has changed the type of silicone gel implant he uses in an attempt to reduce the risk of lymphoma.
Australasian Society of Aesthetic Plastic Surgeons Associate Professor Mark Magnusson says there is very little evidence to support breast implant illness as a specific disease.
But though there is no pathophysiological explanation, there are many women who feel they are affected and he acknowledges some patients do not "co-exist comfortably" with their implants.
"So while the jury is still out on whether or not breast implant illness is fact or fiction, I can tell you that in this day and age breast implants are very safe when you are under the care of a specialist plastic surgeon.
"There are however, a group of women who request the removal of their implants for a variety of reasons and some feel they have breast implant illness. Of this latter group, some experience an improvement in their symptoms, but importantly not all."
Simmons-Villari says she had no issue with cosmetic surgery but wanted to make sure others considered the risks before going ahead with it.
"Each to their own," she says. "I really want people to make an informed decision. I wish that this information was out there when I was going into it."
Simmons-Villari says she believes some women are more prone to the effects than others.
"If you are prone to auto-immune problems then think really carefully about getting implants. I'm not saying don't do it. I'm saying think about it, research it."
Charles Nduka, consultant plastic, reconstructive and cosmetic surgeon at the Queen Victoria Hospital in East Grinstead warns that reversing such procedures is easier said than done.
"Most body modifications are permanent," he explains, adding that "you cannot ever completely undo an operation."
Nduka, who runs the not-for-profit website safercosmeticsurgery.co.uk, says "influenced by social media and celebrities, young people were making impulsive decisions they will come to regret.
"There are no quick fixes, and reversing or revising treatments carries risks."
The most common revision Nduka is tasked with is breast implants, with "nearly all" of those who walk through his doors "looking to downsize their formerly fashionable large implants".
But they don't always realise that stretched skin could lose its elasticity and sag around a smaller implant. "They will need to have skin removed, which leaves 'anchor' scars around the bottom crease of the breast, and up to and around the nipple," he says.
Nduka warns that dermal fillers "can cause hard lumps called granulomas", which "form when the body sees filler as a foreign substance, so encapsulates it with scar tissue. This can make it very hard or impossible to dissolve the filler."
In addition, if patients have overdone procedures, the skin can become stretched and unable to go back to the way it was, which may require a more invasive surgery to fix.
Rhinoplasties (or nose jobs) are the most regretted of all cosmetic procedures. Surgeon Charles East, who specialises in complex revisions and is responsible for restoring Mike Tindall's nose, says that even in the most expert hands, one in 10 patients will go on to have another procedure.
Even Jennifer Aniston has had her nose worked on twice: first, to straighten a deviated septum, then a second procedure in 2007 to correct surgery "incorrectly done over 12 years ago", her representatives said.
And body modifications aren't limited to those of the pumping up kind: tattoos are regretted by one in four, a recent poll found.
"I see young people who have been influenced by stars like Cheryl Cole," says Nduka. "They think, 'I'll get them all lasered off if I change my mind,' but in many cases, even after expensive and painful laser sessions, they are left with ugly, permanent smudges."
So, a word of warning: think of yourself in 30 years' time. Will you still want that cup size, or etching?
If not, avoiding that needle or knife is a decision you really won't regret.
- Additional reporting The Daily Telegraph