ALCL with silicone gluteal implants. How does this change the practice of gluteoplasty?

There was a report of a “textured gluteal implant” associated ALCL out last year from the Department of Plastic Surgery at USC Hospital. However, the manufacturer of the implant was never identified.  Sadly also, the plastic surgeons at USC never even removed the implants from this patient for examination and confirmation that it was, in fact, an actual gluteal (aka buttock) implant and not a textured breast implant, which is not uncommonly used for buttock augmentation, especially in other countries outside the USA.  Instead, the authors only heard from the patient’s understanding of what basic type of implant was placed inside her body.  It is still a medical mystery to me as to why the implant was not examined before reporting such a serious incident and it’s subsequent consequences.  The reason that this is so important is because traditional “textured” buttock implants are not anything like the texturing on the breast implants linked to the relatively high risk of breast implant associated-ALCL (aka “BAI-ALCL“). It has been proven amongst breast implants that those brands with the highest, most sophisticated level of texturing (like velcro or a Brillo pad) that induces more tissue integration are by far more risky for BAI-ALCL compared to other less textured brands.  Now, the texturing on USA FDA approved buttock implants is nothing similar to that of breast implants, rather it is much more like a matte finish pant job, smoother and with no integration of tissue. That all being said, no one can say yet with 100% certainty that any body/face implants other than breast implants will not or can not ever lead to ALCL.  In fact to error on the side of extreme caution, all Stanton Anatomic gluteal implants are now being manufactured with completely smooth surfaces.  Finally, the FDA currently recommends that any patient with textured breast implants not rush to their surgeon for removal but rather keep a close eye on their breasts for any changes whatsoever and follow up with your surgeon if so and on a regular basis.  Hope this helps.  
  

The report from the Jul 2019 issue of Aesthetic Surgery Journal documented the first known case gluteal implant-associated ALCL (GIA-ALCL). The patient received bilateral TEXTURED silicone gluteal implants only a year prior to her diagnosis of GIA-ALCL. The patient later presented to the Plastic and Reconstructive Surgery Department at USC with ulceration at the site of her gluteal implants. Unfortunately, her condition deteriorated before explanation could be performed. The goals of this case report are to provide evidence for the possible new diagnosis of GIA-ALCL so that plastic surgeons are abreast of possible complications.

A single incident or single case report does not prove or show anything. This is not statistically significant whatsoever. Most plastic surgeons in the United States have and continue to use smooth implants. Staying with smooth implants should eliminate the potential risk though never say never and never say always.6000 people die annually from being struck by lightning.High-risk activities include things like driving cars, smoking cigarettes and not having a primary care doctor or routine screening.Thousands of people have had gluteal implants for many years without incidences of this condition.That’s my thoughts. I’m sure there will be others who have a different views.when it comes to gluteal implants this is probably pretty low on the list of concerns. It is highly emotional and highly unlikely. what is much more likely is having contamination of the implant with implant failure leading to disfigurement and need for multiple surgeries. Implant failure has been reported as high as 30% with this procedure. Put in perspective implants are still very safe including textured ones no I don’t recommend using them for Multiple reasons.Best, Mats Hagstrom MD