BIA-ALCL after explant - do I need to test the capsule?

Question

I explanted my smooth mentor implants due to capsular contracture in my right breast. The capsules were left behind. The one that had capsular contracture is thick. I had a seroma in my right breast a few weeks later that was emptied under surgery. My surgeon says that the fluid has been tested negative for BIA-ALCL. Is this enough to rule out that it could be this rare cancer? Or do you have to test the capsule as well? The reason I’m asking is because I still have pain and it’s been a year.

Daniel Barrett, MD · Answer

Dear Elsa9431,
I understand your concern. However, without a proper assessment, it would be difficult to determine is there something wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

BIA-ACLC has not been reported in women with smooth implants only. Your pain could be related to scar tissue, especially close to a sensory nerve. Testing the fluid should be sufficient.  Acupuncture may give you some relief.

Douglas Taranow, DO, FACOS · Answer

It is not  very common to develop a seroma post explantation with the capsules not dissected (it is much more common after a capsulectomy due to the increased open surface area).  It is almost unheard of developing ALCL with smooth shell breast implants.
While pain is one of many symptoms associated with ALCL, I would not perform a capsulectomy to rule it out.
Best wishes.
Dr. Taranow

Layth Gurgia, MD - Account Suspended · Answer

BIA ALCL has been associated with textured implants  BIA ALCL is diagnosed by sending the fluid or tissue to lab.

Best Regards
Dr Layth Gurgia 
Consultant plastic surgeon
Stockholm 
Sweden

BIA-ALCL after explant - do I need to test the capsule?

Answers (4)