I would like to know, after the explantation of an implant, how do we know what to ask, or to look at in the pathology test?

Question

My implant is MÊME (Myers Squibb Bristol), 1989, 160gr, (polyurethane, silicone gel, texture). Does the patient need to ask for specific research? Or the surgeon? Or is it the pathologist who would know what to search for? What is the % of tests show negative but become positive over time?

Camille Cash, MD · Answer

If your implant was sent to a lab for testing the results will be sent to your surgeon.  At the lab the specimen will be examined by a pathologist who will write a report of the findings.  It is the responsibility of your surgeon to discuss those findings with you.  You may request a copy of the pathology report for your files as well.

Genevieve F. Caron, MD · Answer

Thank you, Merci for your questionYour plastic surgeon should ask for specific test on the pathology, he or she will be sending to make sure there is no bad cell (ALCL).You can make sure by askeng your surgeon!Best Wishes
Dr Genevieve FCaron, Board Certified Plastic Surgeon
Montreal, Canada

Benjamin Gelfant, MD, FRCSC (retired) · Answer

Hello from Vancouver,
I had the experience of using fifteen pairs of polyurethane implants early in my practice life, before they were voluntarily taken off the market by Bristol-Meyers. I have removed two pairs, the last over ten years ago. It was well accepted that the polyurethane would be completely gone by seven to eight years after implantation, and this was what I saw in the case I treated. The foam was gone but left  behind a "textured" silicone gel device. Fortunately,  after my experience in the early 90s, I never used textured devices when they became popular among my colleagues in later years. Health canada recently withdrew approval for Allergan to distribute their textured devices due to concerns they are associated with the development of Anaplastic Large cell  Lymphoma ( BIA-ALCL). This is a very rare form of lymphoma but current estimates are about 1:3000 cases with Allergen textured implants. 
There is also a weaker association between ALCL and polyurethane devices. The first signs or symptoms of ALCL usually  involve swelling due to fluid around the implant, visible on ultrasound, or a lump, seen on mammogram. If either of these are present, certain pathology studies are requested by the surgeon ( "CD 30" and others), and the entire capsule is sent to pathology.
If you are not having any symptoms, you should have routine mammography, and keep your implants, if you are otherwise happy with the results. The risks of surgery for no signs or symptoms do not justify routine removal.
Ask questions in a formal consultation with a certified plastic surgeon. You are best to see a member of the Canadian Society for Aesthetic(cosmetic) Plastic Surgery.

Best wishes
Benjamin Gelfant MD FRCSC

I would like to know, after the explantation of an implant, how do we know what to ask, or to look at in the pathology test?

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I would like to know, after the explantation of an implant, how do we know what to ask, or to look at in the pathology test?

Answers (3)

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