Breast Implants & Safety


It is generally known that any medical device, procedure or even a medication that is intended for a benefit can be harmful in particular cases, but how dangerous can a breast implant be?

Lately, I have received many calls and questions from my patients asking what kind of implants do they have, do we need to remove them? Is there any risk?
As we continue to study the long-term effects of breast implants, there’s been a concern about the Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a rare cancer of the immune system. Up to this date, around 500 cases have been reported from millions of patients with breast implants around the world. This is not a cancer of the breast tissue but the immune system. The first symptom is a late seroma, this means a fluid collection that occurs at least 6 months after the insertion of the breast implant which would be evident by the swelling in one breast, on average this happens 8 years after surgery. It is very important to identify these changes early, diagnose and treat properly for a better prognosis. If detected early, the implant capsule should be surgically removed to eliminate this cancer.

Since it was reported almost 20 years ago, The FDA has reported 33 deaths attributed to BIA-ALCL. The individual risk for this problem is from 1:3,300 to 1:30,000 but there is different risk depending on the implant used. This problem has recently gained attention since one of the main breast implant companies recalled all their textured implants, and it caused great concern among the plastic surgery community. This doesn’t mean that patients with that specific brand of implants need to have them removed, but it means that every patient and plastic surgeon must be aware of this issue and look for any symptoms or changes in their breasts for breast cancer prevention.

At this time, no cases of BIA-ALCL have been reported in patients with smooth implants only. The risk for microtextured implants is 1 in 82,000, macro textured implants 1 in 3,200 and polyurethane implants 2,800.
Looking at this data, you might think ”then why not use smooth implants always?” Well, there are other factors into consideration when choosing an implant, as the higher risk of capsular contracture with smooth surface implants (which is a much more frequent complication and commonly leads to reoperations).

I think that this information can be helpful for patients looking to have breast augmentation or reconstruction surgery when choosing an implant, and patients that already have implants to take care of and what to look for.