What Is BIA-ALCL

What Is BIA-ALCL And Should Patients Remove Their Biocell Textured Silicone Gel Implants?

Based on correspondence from their physicians, the media, or the Internet, most silicone breast implant patients by now have heard of the rare type of T-cell lymphoma called Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). This type of lymphoma can develop around breast implants, but is not considered breast cancer. Breast implants have either textured or smooth surfaces and both of these implants have been used for over 30 years worldwide. There is most often a lag time between implantation and the development of the disease, most patients being diagnosed on average around 9 years after implantation. There are several leading theories on the etiology of this rare disease, and as no smooth cases have been identified in any case series, case reports, or implant registries, the disease appears to only occur in patients who have had textured implants. This association may be due to the increase in total surface area produced by the various methods of texturing by manufacturers. The majority of patients who develop BIA-ALCL have presented with a swelling of a breast, called a delayed seroma, a rash on the breast, fever, night sweats, or a breast mass. The majority of patients are completely cured (over 90%) by implant removal with complete capsulectomy, but a comprehensive work-up is required and treatment guidelines have been established by the National Comprehensive Cancer Network (NCCN).

Most of my silicone breast implant patients return routinely every two years for as long as they have breast implants. Exams now include in-office high resolution ultrasound to accurately evaluate the implant and the capsule around them. For those patients whose implants are getting older, greater than 7-10 years or more, I often advise that they remove them and either switch to smooth surface implants, or for some, consider explant alone if they are done with implants. There is an increasing risk of implant rupture as implants age, and revisions are more complicated and lengthier when implants have ruptured than when they are replaced before rupture. For women who have textured implants and are asymptomatic, a capsulectomy is not generally recommended. If there are any abnormal findings during surgery, such as fluid around the implant or an atypical capsule, both would be removed completely and tested for any abnormal pathology. As of July 30, 2019 Allergan, the manufacturer of Biocell implants, is offering any patient who chooses to replace their textured breast implant with smooth devices, replacement implants for free. (Biocell® Replacement Warrantee).

Click here for a comprehensive overview and list of implants from the FDA.

Online Misnomers Regarding Breast Implants

With Allergan’s recent recall of their BIOCELL textured breast implants from the global market, there has been a lot of media attention on breast implant-associated ALCL and what a patient needs to do to protect herself. The online information is often confusing, misleading and, sometimes, down right false. Worse, certain unscrupulous people are preying on patients’ fear, telling them that they need surgery when they do not.

Board certified plastic surgeon Dr. William P. Adams Jr. of Dallas discusses these online misnomers with his colleagues Dr. Pat McGuire of St. Louis, MO, Dr. Mindy Haws of Nashville, TX, Dr. Caroline Glicksman of Sea Girt, NJ and Dr. Anand Deva of Sydney, Australia in order to help patients separate fact from fiction.

Read the full article here.

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Dr. Glicksman is a board-certified plastic surgeon who has been committed to delivering expert, state-of-the-art care for her patients for over 25 years. The doctor performs all of her own consultations, procedures, and treatments and does not use “practice extenders” to care for her patients.

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