Which brand of Breast Implants are the least toxic?

Hi! Thanks for your question. These studies refer to a type of breast implant called a textured breast implant, which has a rough surface designed to adhere to the surrounding tissues. There is a small association of a cancer called ALCL with textured implants, although considered how many implants are placed each year, the risk remains relatively small. Although the FDA has decided not to completely ban textured implants at this time, many surgeons are moving toward using only smooth implants, which have not been linked to cancer or other breast implant illness. To ensure safety and long-lasting results, I would recommend choosing smooth implants, and would also recommend working with a board-certified plastic surgeon experienced in performing breast augmentations with a low rate of complications. In addition, if you choose silicone implants, you may to have regular MRI screenings to prevent leaks from going undetected. I hope you find this helpful!

The textured breast implants are linked to breast implant associated-anaplastic large cell lymphoma (BIA-ALC), a cancer of the immune system.  The FDA reports that BIA-ALCL may develop in 1 in between 3,817 to 30,000 women with textured breast implants (Clemens et al,  2017; Loch-Wilkinson et al, 2017; De Boer et al, 2018).  As of this date, the risk appears to be very small.  In most cases, BIA-ALCL is found in the scar tissue and fluid near the implant but can be widespread. The most common test for ALCL is to take a biopsy of an enlarged lymph node and check it for lymphoma cells. After three years, 93 percent of BIA-ALCL patients are disease-free when the condition is detected and treated early, according to American Society of Aesthetic Plastic Surgery data.
If silicone implants are ruptured, the implants should be removed as well as remaining silicone material that has extruded.  Silicone is relatively inert, and I would not anticipate a change in antibodies after removal.Your PS will be able to explain his/her preference of breast implant manufacturers based upon experience, knowledge, scientific research, and patient feedback.
Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

 Thank you for the timely question. There has been a significant amount of recent discussion regarding lymphoma associated with breast implants as well as breast implant illness. My thoughts regarding these concerns may be helpful to you:Breast implants associated anaplastic large cell lymphoma is a rare variance of lymphoma, that occurs in the fluid or capsule surrounding breast implants. The risk of this occurrence is 1:35,000 at the age of 50 years and 1:7000 at the age of 75 years. Thus far, the lymphoma has been associated with textured breast implants but information is actively being gathered in various national breast implant registries.   There are even some very recent reports that smooth implants may also be associated with this very rare lymphoma. in regards to breast implant illness: There is a very small subset of patients who feel that their breast implants contribute to a variety of illnesses.  This phenomenon has been discussed since the 1960s and has been termed human adjuvant disease, silicone induced human adjuvant disease, autoimmune/inflammatory syndrome induced by adjuvants and silicone implant incompatibility syndrome. Today, systemic symptoms possibly associated with silicone breast implants involve the central nervous system, musculoskeletal system, immune and inflammatory systems, GI and GU systems, psychological system, and the cardiorespiratory sound systems. The term breast implant illness is being used to describe the variety of  symptoms thought to be possibly associated with silicone breast implants.
 You will find, that there is no consensus among plastic surgeons, whether or not there is a link between breast implants and the medical conditions of concern.   In other words, as of today, there is no scientific "causation" shown thus far.  The main theory currently involves a complex interaction of breast implant material with the patient's immune system,  Involvement of bacteria/fungal/virus/other adjuvants, as well as the patient's specific genetic makeup. It is theorized that the "wrong combination" of these parameters may lead to autoimmune disease and/or other associated systemic symptoms.  
 
 Personally  having worked with many patients who have presented with concerns regarding breast implant illness, I think (as thoughtful and humble) physicians, it is important to keep an open mind (even though there is no definitive scientific demonstration of breast implants and specific illnesses except for a very rare lymphoma) and remember (again) that we may very likely do not have a full understanding of breast implants and the potential interactions that may occur with each patient's unique biology.   It is clear, based on the literature and my own anecdotal experience, that a significant percentage of patients who undergo breast implant removal surgery (and capsulectomy)  do experience improvement in symptomatology. On the other hand, a similarly significant percentage of patients continue to  experience symptoms despite breast implant removal/capsulectomy surgery.
 
 Again, the above "information" are simply my personal thoughts in regards to your question. These thoughts may change as more information comes to light.  I hope this helps.