This paper is a review of breast implant illness (BII) from an etiological perspective.1 BII has been discussed under various pseudonyms in the scientific literature, lay media, halls of government, court rooms, and more recently on social media platforms and the internet in one form or another since 1964.2 It is a highly emotive topic that was reported initially as an abundance of case reports and small series followed by a rush of media attention and then an attempt at a more analytic approach with retrospective population-based studies and extensive reviews.3-5 Despite intense focus on a potential relationship, there remains a lack of sufficient evidence to prove an association between breast implants and systemic symptoms. The authors of this paper have reiterated at multiple stages throughout their manuscript that there is insufficient evidence to support an association between saline or silicone breast implants (SBI) and autoimmunity, toxicity, or BII.