Allergan to Provide Implants to Replace Textured with Smooth

Allergan Textured breast implants have been shown to be associated with an unacceptable risk of BIA-ALCL, a cancer of the lymphatic system.   For this reason, these implants were removed from the market on July 24, 2019.   For women with Textured Allergan impalnts, the FDA is not recommending the removal of these textured implants, rather close observation.  Although the lifetime risk of developing ALCL, even with a textured Allergan implant, is quite small (current data would suggest in the range of 1:3,000) I have heard from many patients who would rather exchange these implants and not take their chances.  Reasonable in my opinion.     

How much does it cost to exchange Allergan textured to smooth implants?

Removal of textured implants and exchange to smooth implants can range from simple to complex, depending on multiple factors.   If the patient is overall happy with the result and wants simple removal and replacement just because they are textured, this is relatively straightforward, with a relatively easy recovery and is relatively inexpensive.   Some plastic surgeons will discount the procedure for their own patients.   In our office, doing right for patients is much more important than financial gain and we have substantially discounted this procedure for ALL patients.   Regarding implants costs, as of July 2019, Allergan is providing free smooth implants to those patients.  They are not allowing size changes or change in the type of implant (saline or silicone), and they are not providing other financial support but it is pretty great that they have offered implants free of charge and we applaud those efforts.   

As the complexity of the operation increases, costs do as well.   It is not uncommon for a patient to want a cosmetic change of the breast at the time of this exchange.   These procedures can range from implant resizing, implant repositioning and a breast lift.   These procedures are generally more involved and would be expected to be more costly.   

Should the capsule be removed with the textured implant?

A capsule is simply the healthy scar tissue that a body creates around an implant of any type.   This is not unique to breast implants.  There is no data suggesting capsule removal is beneficial at the time of textured implant removal.   There is a lot of misinformation on the internet (you don’t say) and some are advocating that it is dangerous to leave the capsule behind.   Although that is not the consensus of the FDA and plastic surgery societies many patients fear this is necessary.   It is my opinion that my job is to educate the patient, not tell her what is best for her body.   If it is desired that the capsule be removed, I am happy to do so.   It must be understood that this adds complexity, costs, and recovery to the procedure and can at times negatively impact the cosmetic result.   

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