Implant recall leaves many with questions about their health, safety

By: Cynthia Wall

Dr. Benjamin McIntyre, associate professor of plastic and reconstructive surgery, and one of the specialists who works with women after breast cancer surgery addresses some common questions he’s received since the U.S. Food and Drug Administration began investigating a particular type of breast implant and its links to a rare cancer.

The FDA on July 24 asked Allergan, the implant manufacturer, to recall specific types of implants linked to the Breast-Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). Allergan issued the recall of the specified textured implants the same day.  

McIntyre, who works with the UMMC Cancer Center and Research Institute Interdisciplinary Breast Cancer Program, said the FDA is suggesting women talk to their doctor if they have textured implants but are not suggesting they be immediately removed.

The recall does not affect smooth implants. In a statement, the company said the specific type of implant the FDA identified makes up less than 5 percent of its breast implants sold in the United States.

McIntyre, who services on a committee of the American Society of Plastic Surgeons that has been following the investigation, said he’s receiving multiple questions about it. He answers some here.

Q: What are textured implants and why did the FDA recall them? 

McIntyre: Textured breast implants are a specific type of breast implant with a roughened surface that was designed to reduce the amount of scar tissue forming around an implant which keeps the implant soft and natural feeling. 

Within the past few years, a rare type of breast tumor has been associated with these textured implants. This tumor is called Breast Implant Associated Anaplastic Large Cell Lymphoma or BIA-ALCL. Because of these findings the FDA called for the company that manufactures the implants to recall them and they have.

Q: What is BI-ALCL?

McIntyre: BIA-ALCL is a rare type of lymphoma that forms around a breast implant. There are several theories to why this occurs. The dominant one is this is a result of a chronic inflamed state surrounding an implant that causes white blood cells to behave abnormally. 

Symptoms of BIA-ALCL include swelling around a breast implant or formation of a fluid collection around an implant, typically many years after an implant has been placed.  Other symptoms include a reddened appearance to the skin surrounding an implant which can mimic an infection.

Q: How would a person know if they have textured breast implants?

McIntyre: Typically, when you have breast implants placed, your plastic surgeon gives you a card that states the type and model of breast implant you received.  This may tell you the answer, but if it is unclear, you should contact your plastic surgeon to find out.  Fortunately, textured breast implants have not been as commonly used in the United States as they have been in other countries, but you should still find out if you have a textured implant as you may need more frequent breast exams.

Q: Should women have breast implants removed?

McIntyre: It is important to remember that plastic surgeons can choose from many types of breast implants and the majority are non-textured implants that have no risk of BIA-ALCL forming. 

If you do have textured implants, both the FDA and the American Society of Plastic Surgeons do not recommend routine removal of textured implants in asymptomatic patients, but you should have more frequent breast exams. .

If you have symptoms that may include pain, scar tissue formation, swelling or redness of your breasts, you should have your implants checked by a board certified plastic surgeon. He or she should be able to recommend whether your breast implants should be removed.

Q: Is BIA-ALCL treatable?

McIntyre: Yes. Most of the time, removing the breast implant and the scar tissue surrounding the implant will be curative. 

Some women may need additional chemotherapy or radiation as recommended by an oncologist.  Unfortunately, there have been deaths associated with BI-ALCL. Therefore, anyone who has implant-related symptoms should contact their plastic surgeon and if this cancer is confirmed, they will need appropriate surgical and oncologic treatment.  

Learn more about Dr. Ben McIntyre here.

CCRI Interdisciplinary Breast Cancer team: 601-815-6745