There has recently been an update on the safety of breast implants reported in the media, which has included the proposed cancellation or suspension of certain textured breast implants and tissue expanders. The reports concern the incidence of a rare form of lymphoma, Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL), which has occurred in less than 1,000 cases of the estimated 35 million women with implants worldwide.

As a specialist plastic surgeon, Dr Chris Allen is aware of this issue.  The risks of BIA-ALCL form an important part of his consultation with every prospective breast augmentation patient.

 

 

Is BIA-ALCL Breast Cancer?

It is important to note that BIA-ALCL is not a breast cancer. Breast cancer is a separate disease which impacts around 1 in every 8 women regardless of whether they have implants or not. BIA-ALCL is a rare type of lymphoma which develops adjacent to breast implants and does not involve the breast tissue.

 

What Causes BIA-ALCL?

Most of the scientific evidence suggests that ALCL is related to bacterial growth on the surface of a textured breast implant, in women with associated additional genetic risk factors.

BIA-ALCL is generally observed in women 7-10 years after their surgery and often presents as a swelling or a lump.  Of the 96 cases reported in Australia, the Therapeutic Goods Administration (TGA) has advised that the vast majority of cases were cured by removal of the implant and the capsule surrounding the implant.

There have been no cases of BIA-ALCL in any woman who has only ever had smooth breast implants. It has occurred in women with smooth implants who have previously had textured implants.

 

Am I at Risk of BIA-ALCL?

BIA-ALCL is a rare condition. The most accurate data at present suggests that the risk of this rare type of lymphoma varies from 1:2,800 to 1:86,000 depending on the type of textured surface.  The risk of being diagnosed with any non-Hodgkin lymphoma by age 85 is 1 in 39.

 

What Should I Do If I Have Any Concerns?

If you are concerned about your breast implants, particularly swelling or hardening, please seek medical advice promptly from your GP, or if you had your surgery with Dr Allen please call us on 9382 4811.

The first step is generally to have an ultrasound prior to your consultation with Dr Allen, to investigate the cause of any issue, which in most cases will not be related to BIA-ALCL.

For women who already have textured implants, experts and the TGA have stressed that as ALCL is a rare disease there is no need to remove them unless other medical issues warrant it.  However, we understand that, after considering all the information and evidence, you may choose to have your breast implants removed and Dr Allen will support your decision and guide you through the process.

 

Which Implants?

Mentor Smooth Round gel implants are not affected by the TGA review. However, the Mentor microtextured implants have been proposed for suspension by the TGA. Mentor implants are backed by a 10 year guarantee and have a demonstrated safety record and have been shown in the ALCL research to have amongst the lowest rates of implant-related complications at less than 1 in 80,000 risk.

In the past Mr Allen has also used Allergan and Inamed Implants, which are included in the TGA review.

If you are concerned, please contact us and we can confirm your implant type and provide you with further recommendation.

 

Does Dr Allen Remove Breast Implants?

Yes, in cases of medical complications, or at the request of patients, Dr Allen can remove implants and the capsule, if required.  A breast lift may also be advised.  For more information regarding breast implant removal please don’t hesitate to contact us.

 

Is BIA-ALCL the same as Breast Implant Illness?

Breast implant illness (BII) is a term which is not well defined and tends to be a ‘capture-all’ phrase used by patients with a variety of symptoms that may be experienced by a woman after having breast implants inserted. There are many millions of women with breast implants and in a group of that size we would expect to see a broad array of unusual problems which are completely unrelated to breast implants.

Recent media has featured reports of unexplained or vague illnesses and symptoms (including auto-immune diseases, allergies, migraine, chronic fatigue, joint pain and depression) which women with breast implants have attributed to those implants. The Sydney Morning Herald revealed that some doctors are taking advantage of patients who believe they have BII and are offering to remove their implants, at great expense, with no guarantee it will resolve their symptoms.

There are, however, scientifically validated and well-documented issues associated with breast implants, including capsular contracture, migration, implant rupture which can make patients feel unwell or cause pain.  Removal of the implants will generally make those patients feel healthier.

There is no doubt that some patients just don’t co-exist comfortably with their implants.  This might be due to physical symptoms associated with scar tissue or from the additional weight and for others they may have hard to define symptoms.

If you are experiencing any health issues, you should seek medical advice from your GP or call us on 9382 4811 before making any decision to have your implants removed.

For more information about BII you can read a statement from the Australasian Society of Aesthetic Plastic Surgeons and Australian Society of Plastic Surgeons here.

 

Looking for further information?

As a specialist plastic surgeon, Dr Chris Allen is a member of the Australian Society of Plastic Surgeons (ASPS). You can read their update on breast implant information here.  He is also a member of the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), which is one of the peak bodies for cosmetic surgery in Australia.  Their update is available to read here.

More information is available from the Government’s Therapeutic Goods Administration which recently reviewed this issue.