Is there evidence that gummy bear silicone implants cause lymphoma? How risky are these for breast cancer patients?

Hello,ALCL is a very rare disease that can occur in the solid organs or subcutaneous tissue of the body. It has also been found inside the breast implant capsules of about 120 people.  Although under a microscope the cells look quite the same, the disease is very different when found inside the breast implant capsule. Normally, it is a cancer that requires chemotherapy drugs to cure, and some people die from it.  In ALCL around the breast implant, it is cured by simply removing the implant and all of the surrounding scar capsule, with no risk of local or distant recurrence. Clinical presentation is a woman with well healed breast implants who suddenly develops a seroma (fluid and swelling) around one of them. Ultrasound guided aspiration of that fluid reveals abnormal cells of ALCL.It is true that most people who have gotten this variant ALCL had texture implants, but some had smooth implants. More people had Allergan than Mentor. Most were silicone gel but some were saline implants. None of this explains the etiology of this very rare but easily curable disease.  A clue to it's possible cause is by looking at the cells again. ALCL not associated with implants is of B cell origin, a type of white blood cell important in immune response, mostly in forming antibodies.  ALCL that is associated with implants is of T cell origin, also a white blood cell, but involved with things like fighting bacteria. It has been postulated that this is a disease of chronic inflammation due to bacterial contamination of the implants.  Capsular contracture is another problem of breast implants that is caused by bacterial contamination, but is a very common problem.In summary, gummy bear implants, or any specific type of implant, is not the problem of this very rare condition. It is bacteria, which also causes the most common complication of breast augmentation, capsular contracture. If you want to take steps to ensure your safety and a good outcome with the lowest risk of complications, then choose an inframammary incision by a doctor that uses an implant funnel delivery device. Best of luck!

Thank you for your question.  A rare form of lymphoma has an increased incidence in patients who have had breast implants.  That stated, the cancer is still very rare in these patients.  It is important to have a thorough discussion of the risks of surgery prior to having the procedure.

There has been no conclusive evidence at all showing any kind of definite cause and effect relationship between breast implants and lymphoma.  There have been less than 200 known reported cases worldwide of a very rare, poorly understood condition called Anaplastic Large Cell Lymphoma, or ALCL, and to date they have mainly been associated with a particular texturing process for some implants and not the actual "gummy bear," or highly cohesive gel that is used to fill some of the newer implants, both round and shaped, today.  This is not the same kind of lymphoma that you typically hear about when people need chemotherapy or die of their disease.  In these cases, the condition is isolated to the local tissues, and it resolves upon removal of the implants and capsules. In addition, there have been no studies linking any kind of breast implants to breast cancer in any way, including cause and effect, or late detection/advanced disease at diagnosis.  Thus, to the best of our ability to tell, you should have no different risk of breast cancer with breast implants than you would have without breast implants.  I hope this helps.

Gummy bears have not been shown to increase risk of cancer. However, why are you considering gummy bears; did you know that they can rotate if you are physically active, which would result in severe deformity and require revision surgery. Please make a consultation to discuss details of why you would want a gummy bear. Also, take advantage of our special. Please see link below for examples.

Generally speaking, if you choose to have breast implants placed, the risk of ALCL is extremely small.  Most of us in practice will never see a case in our long careers.  The risks seem to be higher in textured implants so my advice would be to select a round smooth silicone or saline implant.  I agree with the no-touch technique of insertion using a Keller funnel but prefer avoidance of a long potentially visible inframammary scar for my patients.  I normally and routinely recommend either a transaxillary or periareolar incision due to how well they generally heal.  If you have been treated for breast cancer you should discuss all issues with your oncologist and your reconstructive plastic surgeon especially if you are at risk of recurrence or have undergone radiation therapy.These are potentially important issues that may affect your choices and options.  Best wishes.Jon A Perlman MD FACSABC TV Extreme Makeover plastic surgeonDiplomat, Am. Bd of Plastic SurgeryBeverly Hills, Ca.