Breast Implant Illness | Salt Lake City & Layton UT
There has long been a question of whether breast implants could cause breast cancer or other autoimmune reactions, particularly after a rupture where some of the silicone gel entered the breast pocket. That led the FDA to place a 14-year ban on silicone breast implants from 1992 to 2006 when the ban was lifted. The 14-year period allowed extensive research to be done on silicone implants. The FDA found no link between breast cancer or concerning health risks and allowed silicone implants back on the market. Since that time there are two kinds of breast implant issues that have come to light, although the confirmed cases are extremely low. These are called “breast implant-associated large-cell lymphoma (BIA-ALCL)” and “breast implant illness (BII).” BIA-ALCL has been definitively proven to be directly related to breast implants. BII is theoretical at this point and hasn’t been recognized by the medical community as a definitive diagnosis, but that doesn’t mean it doesn’t exist. Neither of these issues has changed the FDA’s position on breast implants at the time of this writing, although these issues are being carefully studied.
What is Breast Implant-Associated Large-Cell Lymphoma?
Breast implant-associated large-cell lymphoma (BIA-ALCL) is a rare type of non-Hodgkin lymphoma that has been found to have an association with a variety of implants, most notably breast implants. It was first identified about 20 years ago. BIA-ALCL has been associated with textured implants, and to date, there have been no cases with smooth-only implants. It has been seen with both saline and silicone implants. As of July 2019, The FDA says there have been 573 world-wide cases of BIA-ALCL. This is out of a pool of 10-35 million breast implantations. Of those cases, 481 have been known to have Allergan textured breast implants. This association led to the halt of sales of Allergan textured implants in 2019. Furthermore, Allergan has initiated the BIOCELL Replacement Warranty and will provide smooth implants to patients with Allergan Textured implants free of charge. This program will run from July 2019 to July 24, 2021.
There is a lot of ongoing research on ALCL and I will update this page as the information is presented. I wrote about the status of ALCL and textured implants in my blog as of July 24, 2019. The biggest risk factor for BIA-ALCL seems to be textured implants. However, not all texture is equal with a much higher risk in “macrotexture” implants and a much lower risk in “microtexture” implants. In the U.S, the only macrotexture implants that were FDA approved were the BIOCELL textured implants made by Allergan. The risk of ALCL with microtextured implants made by Sientra and Mentor is very small and the risk associated with smooth implants is at this point zero. There are theories why BIA-ALCL may occur with textured implants. One is that the increased surface area on textured implants can provide a foothold for bacteria to adhere to the implant, which can then result in long-term inflammation and eventually disease. Another theory blames particulates in the breast capsule or free silicone particles on implant surfaces. The FDA notes there may be a genetic disposition in certain women to be susceptible to BIA-ALCL. It has also been noted that there seems to be a geographic distribution to ALCL. For example, it is being seen more commonly in Australia than in other countries and very few cases have been seen in Asian countries.
Symptoms of BIA-ALCL are persistent swelling or pain in the vicinity of the breast implant. There will usually be evidence of fluid buildup around the breast implant. Some patients have indicated a lump under the skin or capsular contracture. It s important for patients to know that these symptoms are also common without ALCL and ALCL would be rare even in the event of these symptoms.
What is Breast Implant Illness?
Breast implant illness (BII) involves a variety of autoimmune issues. Unlike BIA-ALCL, there are not any specific numbers available, as the symptoms can be due to different conditions and haven’t shown direct links to implants. Plus, it seems that BII occurs more often in women with personal or family histories of autoimmune conditions. Symptoms of BII can include chronic fatigue, fevers, brain fog, and joint pain. Whether these symptoms can be attributed to breast implants is still not entirely known. There are anecdotal reports of many women who have had implants removed who report improvements of symptoms. Alternatively, there are many reports where implants were removed without a change in symptoms. This deserves more study. Many patients with concerns about breast implant illness pursue breast implant removal.
How is Breast Implant Illness Diagnosed?
Unfortunately, the diagnostic test for BII is to remove implants after all other causes of illness have been exhausted. There is no protocol for BII, as the symptoms are related to those with various autoimmune conditions. The cause of the symptoms has not been directly linked to breast implants.
How is BIA-ALCL Treated?
This is a very slow-growing T-cell cancer. It is usually curable through the removal of the implants, fluid and capsules, and any affected tissue around them.
Can You Prevent Breast Implant Illness?
There isn’t enough data on BII to make any recommendations. Of course, if you are concerned about possible risks with breast implants, you may choose they are not right for you. An alternative method of breast augmentation that you may consider is breast fat transfer.
I’ve Heard About These Potential Illnesses and am Reconsidering Getting Breast Implants. What are my Breast Enhancement Options?
An alternative form of breast augmentation that isn’t associated with either of these conditions is breast fat transfer. This certainly has limitations in regards to size of augmentation but is a “natural” alternative.