Recently the Federal Drug Administration (FDA) released information on breast implant associated anaplastic large cell lymphoma (BIA-ALCL) a rare tumor associated with textured breast implants used in breast reconstruction and cosmetic breast augmentation. This rare tumor has been studied and updates provided since 2011.
What is BIA-ALCL?
Breast implant associated anaplastic large cell lymphoma is a rare form of lymphoma that develops adjacent to textured breast implants. Only about 300 cases have been reported in an estimated 5,000,000 patients with breast implants. An estimated risk in patients with textured breast implants is 1 in 30,000. BIA-ALCL has never been reported in patients with smooth walled silicone or saline breast implants. BIA-ALCL is NOT BREAST CANCER.
What is a textured breast implant?
Most silicone and saline breast implants have a smooth outer silicone rubber shell that contains either silicone gel or saline. Textured breast implants have a rough, irregular pebbly surface that is not smooth. See the image below: to compare textured breast implant with smooth walled breast implant.
Why were textured breast Implants used?
Textured breast implants were developed because studies showed that textured breast implants were less likely to develop hardening of scar tissue around the breast implant, a condition called capsular contracture.
In addition, the wall of the textured breast implant is thicker, more rigid and allowed for the production of specially shaped, tear drop shaped breast implants which had advantages in breast reconstruction after mastectomy and in some cosmetic cases.
What are common problems with textured breast implants?
While textured breast implants have been used successfully, mostly in breast reconstruction, there are some issues unique to textured breast implants that have made widespread use in cosmetic breast augmentation less common than smooth walled breast implants.
First, because the textured implant wall is thicker oftentimes the textured breast implant does not feel as soft as a smooth walled breast implant. In addition, because of the adherence of the textured implant wall to the surrounding tissues, the textured breast implants do not move as naturally with the body, and are not as freely movable within the breast implant pocket as are smooth walled breast implants.
Finally, if implant removal becomes necessary for any reason, the textured implant is adherent to the surrounding tissues and can be difficult to remove.
How often are textured breast implants used for cosmetic breast augmentation?
At a recent meeting of the American Society of Aesthetic Plastic Surgeons (ASAPS), a society of Board Certified Plastic Surgeons with experience and expertise in Aesthetic Plastic Surgery a survey was held in a course on breast augmentation/lift. The result of the survey was that 83% of these experienced surgeons present use smooth walled cohesive silicone gel breast implants.
What are the signs or symptoms of BIA-ALCL?
- Swelling of the breast due to fluid accumulation called a seroma.
- A palpable lump on the implant usually attached to the breast implant capsule, a memberane that forms around all breast implants normally but when abnormal, thickens and tightens around the implant.
- Average onset of symptoms is 8 years after implant placement but the range is 3-14 years.
How is BIA-ALCL diagnosed.
Physical exam by your Boston plastic surgeon especially if you develop swelling or a lump in the breast and have textured breast implants.
If fluid accumulation is expected an ultrasound exam is done to confirm the presence of fluid, and fluid is drained to examine the fluid for presence of cells associated with breast implant associated anaplastic large cell lymphoma.
What should I do if I have textured breast implants?
BIA-ALCL is a rare occurrence even in patients with textured breast implants and fortunately produces detectable symptoms of seroma and can produce a lump or mass that can be felt on breast exam.
First be aware of whether you have textured breast implants by contacting your plastic surgeon or the facility where the implants were placed. Be conscious and aware of your breasts and if you develop swelling, especially on one side, or detect a lump, see a board certified plastic surgeon for an examination and possible ultrasound.
What if I develop BIA-ALCL?
Fortunately, BIA-ALCL is curable. The implants and implant capsule around the implants are removed completely. All known cases where diagnosis was not delayed have been 100% cured to date.
Can I have new breast implants after textured implants and BIA-ALCL is removed?
Yes, after an appropriate time for healing new smooth walled cohesive silicone gel or saline implants can be used to replace the previous textured breast implants.
What type of breast implants are used by Boston Plastic Surgery Specialists for cosmetic breast augmentation?
We do not use textured breast implants for cosmetic breast augmentation. We use only smooth walled cohesive silicone gel or saline breast implants made by Mentor. Mentor breast implants are the only brand made in America and I have been using them successfully for 37 years.
Where can I find more information about Breast Implant Associated Anaplastic Large Cell Lymphoma occurring with textured breast implants?
Further information on breast implant associated-anaplastic large cell lymphoma can be found online at: