Over the last few weeks, I’ve received many questions from patients who were concerned about recent news reports suggesting a possible link between textured breast implants and a cancer called ALCL. These questions have been great, so I wanted to share some important information on this topic as well as dispel some of the myths.
What is BI-ALCL?
Known as Breast Implant Associated Anaplastic Large Cell Lymphoma, BI-ALCL is a type of cancer that originates with lymphocyte cells in your immune system. When these cells are functioning normally, their job is to protect your body from infections. However, in the case of BI-ALCL, lymphocytes begin growing uncontrollably. If left untreated, these cells can spread to other parts of the body and may lead to death.
Do Textured Implants Cause ALCL?
The short answer is: no one knows exactly. In a February 2017, the FDA stated that it has received 359 reports linking implants to ALCL over the last few years. Of these, only 231 reports had data on the type of implant used, with 203 being textured implants and 28 being smooth implants.
When you consider that millions of textured implant procedures have been performed throughout the world, the chances of developing BI-ALCL look slim for the average patient. It’s also important to note that of the 359 reported cases gathered by the FDA, nearly all of them were cured by removal of the implant and capsule. The unfortunate aspect of this condition is the reports of 9 deaths due to BI-ALCL.
So does this mean that textured implants are perfectly safe? No. In fact, I believe that the instances of ALCL in relation to textured implants have possibly underreported. The medical community has become aware of this possible link fairly recently, and data is still being gathered.
However, the figures that we do have so far suggest that the connection between textured implants and ALCL isn’t clear-cut. It also doesn’t explain how the textured implants could be causing occurrences of ALCL, and if there are other factors at play.
This is one of the reasons why a lot of the recent reporting on this topic hasn’t been very effective. Many websites seem to have published this news with a slant that unnecessarily instilled fear in many patients. Certainly, this is something that needs to be discussed, but over-blowing the probability of developing ALCL does nothing to help the patient. It simply creates unnecessary anxiety and stress.
Why Use Textured Implants at All?
One of the reasons why textured implants were developed was to help reduce the movement of the implant in the body. With shaped implants we don’t want the implants to rotate, as that can cause the breasts to appear misshapen or lopsided, and may lead to other complications. There is some thought that texturing can help prevent implants from sliding to the side or down the chest wall. Also, textured implants have a lower rate of capsular contraction.
The benefits of preventing rotation aren’t just physical or aesthetic, but psychological as well. Preventing rotation of with textured implants goes a long way in helping the patient feel comfortable and confident, and reducing unnecessary reminders of their surgery.
If I have Textured Implants, What are the Symptoms of BI-ALCL?
If you have textured implants and are worried about BI-ALCL, there are several symptoms to watch out for, including the hardening of one or both breasts, change of breast shape, fluid buildup around the implant, and any pain in the breast(s). In many ways the symptoms of BI-ALCL are very similar to the symptoms of capsular contracture, which I discussed in one of my previous articles.
How is ALCL Diagnosed?
If you are worried about ALCL, the best step to take is to schedule a consultation with your plastic surgeon. He or she will be able to perform an examination, answer your questions, and discuss your risks in greater detail. If you’d like a second opinion, you can also call my practice and I’ll be happy to provide you with a second opinion.
When it comes to obtaining a definitive diagnosis, the only way to really achieve this is by removing the implants and performing a biopsy on the surrounding tissue.
Should I get a Textured or a Smooth Implant?
If you’re thinking of undergoing a breast augmentation, the decision of a textured vs. a smooth implant is a very personal one. The preliminary data suggests a higher risk of developing ALCL with a textured implant, but the overall risk appears relatively low.
At the end of the day, a big part of your decision has to be psychological comfort. A good question to ask yourself is whether you’re more comfortable with a greater risk of capsular contraction and malposition or the possibility that you may possibly develop ALCL from a textured implant.
The Bottom Line
It’s important to be objective about the current statistics, and to keep in mind that at this point it appears your chances of dying in a car accident are much greater than the chances of developing ALCL from textured implants.
However, because the possibility is still there, it’s a good idea to meet with your surgeon to discuss this topic, especially if you’re experiencing any of the symptoms. It’s all about creating a good balance between being objective about the data, not driving yourself crazy, but still taking precautionary steps to keep yourself safe.
