Am I high risk for developing BIA-ALCL?

Question

I have ehlars-danlos syndrome very loose skin with snoopy deformity and huge 995cc Silimed textured cohesive silicone gel implants. Iv only just found out the were pulled from the uk. And only just heard about BIA-ALCL, whilst researching breast implant illness which I now realise is what has made the past 8 years of my life a misery. I have almost all the symptoms. By the way I had my implant to stabalize a severe chest pain. Which it did but now the skin is loose again they are useless. Please help

Vincent N. Zubowicz, MD · Answer

I think you have very little to worry about relative to large cell lymphoma. The incidence is not zero but it is extremely modest. On the other and you have very good reason to remove for exchanger implants. The text relation did not prevent the recurrent ptosis. Other options are available for volume enhancement including fat grafting in selected patients.

Emmanuel De La Cruz, MD · Answer

Hello bluebell77,
I’m sorry for the adverse symptoms you are experiencing. Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a T-cell lymphoma that can develop following breast implants. ALCL is a type of non-Hodgkin's lymphoma, a cancer of the cells of the immune system. It can occur in many different parts of the body, including the lymph nodes and skin. Even though BIA-ALCL is found in the breasts of some individuals (cis- and trans-gender women and men) with breast implants, it is not breast cancer. In the UK, the estimated risk of BIA-ALCL, based on the reported confirmed cases is 1 per 28,000 implants sold. This estimate is based on data for all types of breast implants known to be sold in the UK and reported cases of BIA-ALCL confirmed to meet the World Health Organisation (WHO) criteria until December 2017. This is an estimate as some cases may not have been reported to the manufacturer or to the Medicines and Healthcare Products Regulatory Agency (MHRA) during this period, additionally all devices known to be sold in the UK may not have been implanted. Because the risk of ALCL appears very small, breast implants continue to be considered safe and effective when used as labeled. Up to date, there is no certainty about the specific cause-and-effect relationship between breast implants and ALCL. Most data comprised in medical device reports suggest that BIA-ALCL occurs more frequently following implantation of breast implants with textured surfaces rather than those with smooth surfaces. Currently, it is not possible to identify a type of implant (silicone versus saline) or a reason for implant (reconstruction versus aesthetic augmentation) associated with a smaller or greater risk. Half of the reported cases were diagnosed within 7-8 years post-implantation. Most patients were diagnosed when they sought medical treatment for implant-related symptoms such as persistent seromas, capsular contractures, or peri-implant masses warranting breast implant revision operations. In each case, lymphoma cells were found in the effusion fluid (seroma) surrounding the implant, in the fibrous capsule, or within a peri-implant mass. Fortunately, BIA-ALCL tends to remain confined around the breast implant and most patients have a good prognosis when they receive the appropriate treatment. It is essential for you to understand the importance of consulting with your plastic surgeon since he/she may be the specialist most knowledgeable about this rare disease process as well as the person most appropriate to coordinate the necessary evaluation and treatment. With regards to implants size, going beyond the recommended size based on your breast parameters is associated with higher risk of complications, including poor scarring, bleeding, breast sagginess, implant mal position, thinning of the overlying breast tissue, rippling, palpability, and implant exposure and extrusion. Consult with your plastic surgeon to assess your candidacy for breast implant revisionary surgery. Hope this is helpful! Dr. De La Cruz.

Robert H. Hunsaker, MD · Answer

While there is a small risk of developing this rare lymphoma, your risk is higher due to the presence of textured implants. Having said this, unless you have any signs or symptoms of it (most commonly a fluid collection around the implant) it is not recommended to remove or change the implants solely because of this. Your other issues may or may not be related to your implants. You should discuss these with your doctor.

Am I high risk for developing BIA-ALCL?

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Am I high risk for developing BIA-ALCL?

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