Breast Implant Illness

BII Testing Checklist

A complete reference for testing the damage breast implants cause — organized by category, with direct-to-consumer lab options and the clinical language to use when a physician won't cooperate. Print and bring to appointments, or use as a reference for self-ordering.

Run the full panel before explant to establish baseline and document medical necessity. Repeat key markers at 3, 6, and 12 months post-explant to track recovery. Return to the full article at breast-implant-illness.html for the clinical rationale behind each test.

Full Article

BII Testing Checklist — The Undoctored

theundoctored.com/breast-implant-illness.html  ·  Run before explant. Repeat at 3, 6, 12 months post-removal.

Imaging — Structural Integrity
Breast MRI without contrast
Gold standard for rupture, gel migration, intracapsular vs. extracapsular break. Refuse gadolinium.
Axillary lymph node ultrasound
Specifically to assess silicone migration to regional nodes. Often missed on general breast ultrasound.
Thermography (infrared)
Radiation-free baseline; shows asymmetric inflammatory heat signatures.
Inflammation & Immune Activation
TGF-β1 (Transforming Growth Factor Beta 1)
Elevated in BII and biotoxin illness. Drives fibrosis and capsular contracture. Dual marker.
High-sensitivity CRP (hs-CRP)
More sensitive than standard CRP for chronic low-grade inflammation.
ESR
Nonspecific; often elevated in active BII.
IL-6 (Interleukin-6)
Pro-inflammatory cytokine; correlates with fatigue severity in BII.
ANA with reflex autoimmune panel
If ANA positive: anti-dsDNA, anti-Sm, anti-SSA/SSB, anti-Scl-70, anti-Jo-1
Complement C3, C4, and C4a
C3/C4 low in autoimmune disease. C4a elevated in mold/biotoxin illness.
Complete lymphocyte panel — CD4/CD8 ratio
T-cell immune dysregulation pattern.
CD57 (NK subset)
Depleted in chronic illness and immune exhaustion. Marker of biological depletion.
Detox Capacity & Nutrient Depletion
Organic acids test (OAT) Specialty lab
Great Plains Lab or Genova Diagnostics. Mitochondrial function, detox capacity, gut dysbiosis, oxalate, B-vitamins, neurotransmitter metabolites.
MTHFR genotyping (C677T and A1298C)
Methylation capacity. Compound heterozygous or homozygous = significantly impaired detox; requires different support approach.
COMT + GSTM1/GSTP1 genotyping
Estrogen metabolism and glutathione conjugation capacity. GSTM1 null variant is common and indicates reduced toxin elimination.
RBC magnesium (not serum)
Intracellular magnesium; serum magnesium is meaningless for assessing tissue stores.
Zinc, copper (serum), ferritin
Copper-zinc ratio; iron stores. Common depletion pattern in chronic illness.
Active B12 (holotranscobalamin), B6 as P5P, RBC folate
Active forms only — serum B12 and standard B6 miss functional deficiency.
Omega-3 index
EPA+DHA in red blood cell membranes. Below 4% = significantly pro-inflammatory fatty acid ratio.
Mold & Biotoxin Burden

Critical for saline implant recipients — mold growth inside the implant is documented in clinical cases.

Urine mycotoxins Specialty lab
GPL-MycoTOX (Great Plains Lab) or Vibrant Wellness MycoTOX. Tests aflatoxins, ochratoxin A, trichothecenes. Urine — no blood draw.
MMP-9 (Matrix Metalloproteinase 9)
Elevated in mold illness and chronic inflammation. Standard lab order.
MSH (Melanocyte-Stimulating Hormone)
Depleted in biotoxin illness. Low MSH: chronic pain, sleep dysregulation, immune dysfunction.
VEGF (Vascular Endothelial Growth Factor)
Elevated in mold illness and some BII presentations. Physician order required.
Heavy Metals & Implant-Specific
Urine heavy metals — platinum, titanium, aluminum
Unprovoked baseline urine preferred. Platinum specifically from silicone catalyst — must be requested by name; not in standard panels.
Serum platinum
Specific test for silicone-derived platinum. Request explicitly.
Hair tissue mineral analysis (HTMA)
Chronic exposure pattern over months; not subject to hourly blood fluctuations.
Silicone antibody panel Specialty lab
IgG, IgM, IgA immune response to silicone compounds. Immunosciences Lab (immunoscilab.com).
MELISA test Specialty lab
Lymphocyte reactivity to metals and silicone. More validated than standard LTT. MELISA Diagnostics (US samples accepted).
Hormonal, Metabolic & Liver
Full thyroid panel
TSH, free T3, free T4, reverse T3, TPO-Ab, TG-Ab. "Normal TSH" is not a full thyroid assessment.
Sex hormones — full panel
Estradiol, progesterone, testosterone (total + free), DHEA-S, SHBG
4-point salivary cortisol
AM / noon / PM / bedtime. Serum cortisol captures only one point of the diurnal curve.
GGT (Gamma-Glutamyl Transferase)
Phase II liver detox and glutathione production indicator. More sensitive than ALT/AST for chronic toxic load.
Homocysteine
Methylation pathway marker. Elevated = impaired methylation; detoxification and immune regulation are compromised.
Insulin, fasting glucose, HbA1c
Metabolic inflammation and insulin resistance pattern.
At Explant — Request Before Surgery In writing
Capsule pathology with CD30 immunostaining
Required to rule out BIA-ALCL. CD30 staining is NOT included in standard pathology — must be specifically requested by name.
Capsule fungal and bacterial culture
Separate from implant contents. Assesses biofilm and mold in the capsule tissue itself.
Implant contents culture
The saline or gel inside the implant — cultured separately for mold and bacteria. Implants are often disposed of without culturing unless the patient requests it in advance and in writing.
Capsule tissue for cyclosiloxane analysis Specialty lab
Not standard. Specialty environmental labs. Documents D4/D5/D6 presence in periprosthetic tissue.
Direct-to-Consumer Lab Options — When Your Doctor Won't Order

Standard bloodwork

  • Ulta Lab Tests (ultalabtests.com)
  • Everly Well (everlywell.com)
  • Function Health (functionhealth.com)
  • Quest Patient Direct (questdiagnostics.com)
  • LabCorp Patient Direct (patient.labcorp.com)

Specialty testing

  • Great Plains Lab — OAT, mycotoxins
  • Vibrant Wellness — mycotoxins, micronutrients
  • Immunosciences Lab — silicone antibodies
  • MELISA Diagnostics — material reactivity
  • Genova Diagnostics — OAT, hormone panels

What to say to your doctor

"I need a comprehensive autoimmune and inflammatory workup — I've had a foreign body implant for [X] years and I'm experiencing systemic symptoms that haven't been explained." Bring the FDA's 2019 and 2021 breast implant safety communications. If refused, ask for the refusal documented in your chart with the clinical reasoning.

The Undoctored  ·  theundoctored.com  ·  Educational content only — not medical advice.  ·  For the full clinical rationale behind each test, including mechanisms and research citations, see breast-implant-illness.htmltheundoctored.com/breast-implant-illness.html.