The short answer: It is a personal decision, but doing so comes with more risks if you have the MTHFR gene mutation.
The long answer: Breast implant illness is a real threat to any woman who gets breast augmentation. However, if you have the MTHFR gene mutation, you are especially at risk. I do not have any personal experience with this topic, but a disproportionate number of women who develop breast implant illness also test positive as being homozygous for one of the MTHFR variants.
Symptoms of breast implant illness include extreme fatigue, headaches, achy joints, sudden development of food intolerances, and sudden onset of autoimmune diseases, just to name a few. It is a myth that the material of the breast implant is the main factor in triggering breast implant illness. Whether you get silicone or saline implants, it is the body's immune response to a foreign object being implanted so close to the vital organs that causes the symptoms.
Without going into a huge scientific dissertation, those with the MTHFR mutation already have compromised immune systems and have a difficult time breaking down and flushing toxins from the body. When the implants are placed, the immune system gears up to rid the body of these foreign invaders. This is the case for all women, regardless of MTHFR variant.
However, when you have this mutation, your immune system is already at a disadvantage. When an immune system is overwhelmed enough, it will switch from attacking the foreign invader to attacking itself. That is what essentially happens in breast implant illness and those with the MTHFR variant are already positioned to be closer to making this switch in their immune systems than those without the mutation.
Important note: It is important to note that if you wish to remove your breast implants for this reason, your surgeon must remove the implants with the capsule that your body created to contain it. This capsule will contain high levels of toxins that your body has attempted to capture. In most cases, it is considered unnecessary to remove this capsule because the body will reabsorb it and flush the toxins. However, if you have the MTHFR mutation, you will have a harder time flushing these toxins, if at all. The capsule must be removed.
So what can I do? I would never encourage another woman to surgically enhance her body or to attempt to live up to an impossible standard of beauty. However, I also realistically understand that many women strongly desire to enhance their breasts and have personal reasons for wanting to do so, including reversing damage from breastfeeding.
While all surgeries come with risks, my research suggests that fat transfer is a better option. Fat transfer involves the liposuction of fat from areas such as the abdomen or thighs and then transferring it to the breast tissue. The results can be very natural looking (as it is your own fat) and long-lasting. There is no possibility of rejection or an immune system response, as no foreign material is inserted into the body. Chance for infection exists, but is low. Fat transfer, however, does not allow for dramatic changes in breast size. One cup size is the average amount of increase possible.
The primary risk of fat transfer is lumpiness (calcification) that could cause false alarm on a mammogram. From what I understand, avoiding this outcome is largely dependent on the skill of the surgeon. A breast lift with or without fat transfer is also a viable option for those wishing to restore breasts after breastfeeding or the effects of aging.