BIA ALCL & Breast Implant Illness


Breast implants have been available since the mid-1960s and have increased in popularity among patients in all areas of the world. Most recently they were extensively studied for more than a decade and found to very rarely produce side effects. Currently, however, there have been reports regarding two conditions that raise concern among many patients that have breast implants: Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) and Breast Implant Illness (BII). Breast implant patients are faced with information regarding these two conditions from the news, internet sites, and social media groups. It may cause some uncertainty on what information is accurate and how to go about a future with having breast implants. Although the type of implant most associated with BIA-ALCL was not widely used by Dr. Ghaderi, we have accumulated information on both BIA-ALCL and BII for our patients. We want to make sure you have as much information as possible, answer concerns, and help in the decision-making process on what to do next. 

What is Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)?

Breast Implant Associated Anaplastic Large Cell Lymphoma is a rare form of lymphoma. This type of lymphoma is cancer that develops within the capsule that forms naturally around the implant. It is not cancer that develops in the breast. It has been reported that the highest risk of BIA-ALCL is associated with textured surface breast implants, particularly Allergan BIOCELL textured breast implants (1:3,200). There are NO confirmed cases of BIA-ALCL associated with smooth surface implants. 

Symptoms of BIA-ALCL include swelling of one breast, hardening of the breast, persistent rash, or palpable mass in the breast or armpit. If you are experiencing any symptoms, it is recommended to be evaluated by a plastic surgeon.  At that time further tests could be recommended such as an ultrasound or MRI. If treated early, BIA-ALCL is almost always completely curable with surgery alone (removing the textured implants and the capsule), but if untreated, it can be more serious. 

What is Breast Implant Illness (BII)?

Breast Implant Illness is a term used by women to describe systemic symptoms they are experiencing due to their breast implants. Some of the symptoms being noted are fatigue, chest pain, hair loss, headaches, chills, photosensitivity, chronic pain, rash, body odor, anxiety, brain fog, sleep disturbance, depression, neurologic issues, and hormonal issues. They feel these symptoms are directly connected to their saline or silicone breast implants, both smooth and textured surfaces. 

Currently there is no diagnostic testing specifically for Breast Implant Illness. This is one of the current areas of focus for the Aesthetic Surgery Education and Research Foundation. In 1999, The Institute of Medicine Committee on the “Safety of Silicone” conducted an extensive review of the available literature and concluded there was no demonstrated clear link between silicone implants and any systemic illness. Studies of patients who have symptoms that they have related to their breast implants have not shown consistent laboratory abnormalities to define a distinct syndrome. 

Is Breast Implant Removal Recommended?

As of July 24, 2019, a voluntary recall of Allergan’s unused BIOCELL products was implemented. This recall was a withdrawal of BIOCELL implants from future use. Given that information, the FDA still does not recommend removing or replacing Allergan BIOCELL textured implants in patients who have no symptoms of BIA-ALCL. 

If a patient with Allergan BIOCELL textured implants decides to have her breast implants removed or replaced, Allergan will provide Allergan smooth implants free of charge with their BIOCELL Replacement Warranty. Details of the warranty can be provided by a plastic surgeon’s office. The warranty for a smooth implant replacement is in effect until July 24, 2021.

As far as Breast Implant Illness (BII), current research does not directly link implants with an autoimmune illness. Therefore, there is no guarantee that symptoms will improve with implant removal. The Aesthetic Society is currently funding a variety of scientific studies through the Aesthetic Surgery Education and Research Foundation to dig deeper into potential causes of the symptoms being experienced by breast implant patients and will then be able to determine the best treatment. 

If you are considering breast implant removal, it is highly recommended to meet with a plastic surgeon to discuss possible surgical options. The plastic surgeon will address any symptoms being experienced and discuss the risks and benefits of removing your breast implants. 

Sources:

https://www.surgery.org/

Mcguire, Patricia A, et al. “Breast Implant Illness: How Can We Help?” Aesthetic Surgery Journal, 25 Sept. 2019, pp. 1–4., doi:10.1093/asj/sjz227.

To learn more contact us today. Our staff is happy to answer questions.