As breast augmentation is one of the most popular cosmetic procedure, since their FDA approval in 1962 the safety of implant-related complications has been broadly disputed. Although decades have passed, breast implant illness still represents a poorly defined and controversial complication. With an upcoming nonscientific discussion on mainstream media and social media, revealing BII’s etiology is quite urgent, finally influencing patients’ decision and creating a trustful doctor-patient relationship. Up to now, little or no scientific research is available on BII and no final conclusion regarding its etiology, clinical manifestations, diagnostic criteria or treatment has been made up to now. This review aims to give an overview of etiology hypothesis of BII and seek inspiration to improve BII patients’ conditions.

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Background: In an era where textured devices are being phased out due to concerns about BIA-ALCL, the Motiva SilkSurface breast implants intend to alleviate historical prosthesis-related complications. However, its safety and feasibility remain unelucidated. Methods: An analysis of Pubmed, Web of Science, Ovid, and Embase databases was performed. A total of 114 studies were identified initially, and 13 of these met the inclusion criteria and were assessed regarding postoperative parameters such as complication rate or follow-up period. Results: In 4784 patients who underwent breast augmentation with Motiva SilkSurface breast implants, a total of 250 (5.2%) complications were observed. Short- and medium-term complication rates ranged from 2.8–14.4% and 0.32–16.67%, respectively. The most common complication was early seroma (n = 52, overall incidence = 1.08%), followed by early hematoma (n = 28, overall incidence = 0.54%). The incidence of capsule contracture was 0.54% and breast implant-associated-anaplastic large cell lymphoma was not observed. Discussion: Although the majority of the studies in the current literature suggest the distinction of the Motiva SilkSurface breast implants in terms of postoperative complications and capsular contracture, its safety and feasibility need to be further elucidated with well-designed, large-scale, multicenter, prospective case-control studies. Other: No funding was received.