As a member of the American Society of Plastic Surgery, I receive our society’s journal in print. This month’s supplement was about BIA-ALCL: Breast Implant Associated-Anaplastic Large Cell Lymphoma. I wanted to share what I read.
BIA-ALCL is a rare and “highly treatable type of lymphoma that can develop around breast implants. Data show that BIA-ALCL occurs most frequently in patients who have breast implants with textured surfaces.”
To date, all confirmed cases have involved exposure to a textured implant or expander.
One case has even involved a textured buttock implant.
The breast implants I use in my practice for standard breast augmentation are NOT textured. I use smooth breast implants.
I perform buttock augmentation using fat grafting, not implants.
Breast implants are used in both aesthetic breast augmentation as well as breast reconstruction for breast cancer. BIA-ALCL has been noted in both, but again, only in textured implants (or expanders).
No medical device is without risk. The estimated rate of is BIA-ALCL 1:30,000 for every patient with breast implants. For comparison, the odds of being struck by lightning during one’s lifetime is 1:3000.
Current evidence suggests that inflammation due to bacteria may be the cause of BIA-ALCL. Most board-certified plastic surgeons use a one-touch technique to minimize the risk of bacterial contamination of breast implants.
The most common presentation of BIA-ALCL would be with a fluid collection around a breast implant, about 8-10 years after the initial surgery.
During all my years of practice, including my years of surgical training, I never encountered a case of BIA-ALCL. It’s a rare disease.
Globally, there have been 600 reported cases across 25 countries. The lowest rates are in European, Asia, and South-American countries. Australia and New Zealand have reporting the highest incidence.
For aesthetic breast augmentation, textured implants were more commonly used above the muscle.
If you have breast implants and want to know if they are textured, you may check the back of your breast implant card. Otherwise you may contact the hospital or your doctor. As a last resort, if you had your breast implants in the US, you can try to contact each of the three breast implant manufactures: Mentor, Allergan, and Sientra.
In conclusion, I think that Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is something important to know about.
If you are considering changing textured implants to smooth implants, removing breast implants, or going from implant based to tissue-based breast reconstruction, I would be happy to speak with you.
