Dr. Alexis L. Parcells, MD, wants to remind women that “Breast implants are not life-long devices.” Parcells, a plastic surgeon who performs breast surgeries and also volunteers for several breast cancer organizations, recently published an article on her website alerting breast implant recipients that the U.S. Food & Drug Administration (FDA) recommends that women with silicone implants have an MRI around every three years to check whether they are still safe.
Parcells acknowledges that many women do not follow up on the FDA’S recommendation, as an MRI for this purpose would be an out-of-pocket expense.
She encourages these women to conduct self-breast exams, and she details the signs that a woman’s breast implants might need to be replaced. These signs include:
- Hardening or tightening of the breast capsule or scar around the implant
- Rupture of the implant
- Change in position over time
- Breast-Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) and Breast Implant Illness (BII)
The last sign on Parcells’ list seems to come from left field, but the surgeon wrote about the weighty topic of BIA-ALCL in a previous article.
Breast-Implant Associated Anaplastic Large Cell Lymphoma
In her article dated July 30, 2019, Parcells updated readers on new developments in BIA-ALCL, informing them that major breast implant manufacturer Allergan had voluntarily halted production of its textured implants and tissue expanders called BioCell.
Parcells let her readers know that Allergan would provide free smooth implants for any of its textured implant recipients—but the patients would need to cover the costs of anesthesia, surgery, etc. She also drew readers’ attention to the relatively low number of reported BIA-ALCL cases to date.
Important Facts About BIA-ALCL
It seems appropriate to call to the forefront some important facts aboutBIA-ALCL, to help round out Parcells’ discussion of the topic.
- The reported numbers are inaccurate: One should note that plastic surgeons who specialize in breast implant surgeries typically focus on the relatively low number of BIA-ALCL cases, compared with the total number of implants. In its “Current Risk Estimate of Breast Implant-Associated Anaplastic Large Cell Lymphoma in Textured Breast Implants,” Plastic and Reconstructive Surgery concludes that it is hard to accurately estimate these numbers due to underreporting, inadequate registries, low awareness levels, and fear of lawsuits. This problem was reported by the World Health Organization in 2016, which noted that the exact number of cases was difficult due to “significant limitations in world-wide reporting and lack of global breast implant sales data.”
- The risk is increasing: The results of the Plastic and Reconstructive Surgery scientific review showed that the number of BIA-ALCL cases and risk of the disease had increased significantly “from initial reports of 1 per million to current estimates of 1/2,832.”
- The FDA warns of the higher risk of BIA-ALCL for textured surface implants: The agency instructed health care professionals to immediately cease implanting textured implants and tissue expanders and return existing inventory.
- Symptoms of BIA-ALCL may appear years after receiving the implant: The FDA cautions patients to be aware of the following signs:
- A pain or mass in the breast implant area
- Persistent swelling
Signs and symptoms may manifest years later, well past the healing of the surgical incision.
Forewarned is forearmed. Perform self-checks and talk to your healthcare provider so you can make informed decisions about receiving, removing, or replacing your breast implants. Keep in mind that several hundred breast implant recipients have filed lawsuits against Allergan claiming that they developed BIA-ALCL from the company’s textured implants.