Is the risk of developing BIA-ALCL eradicated when implants are removed?
Thank you for your question. The general risk of IA-ALCL is very rare, recent data suggest about a 1/500,000 risk. This can be lower depending upon the type of implant- saline, silicone with smooth shell is least likely to be at risk. If there are no suspicious findings at time of removal, then it would not be standard to have the capsule sent for evaluation. One can always request that this is done by your surgeon if there is a concern. I would recommend a face to face consultation with a Board Certified Plastic Surgeon who has experience in this area to help you assess your specific concerns.
ALCL is such a rare condition that we do not have enough evidence to answer this question. My personal guidance to patients is included belowThe current guidance is that an USS is the first step for investigation of at risk patients - i.e. those with masses / late onset seromas. My personal practice is to perform enbloc capsulectomy and sending the capsule for pathology and the fluid for analysis (if present). I personally send a sample of the capsule in all revisionary cases and prefer to offer total capsulectomy at time of revision (if the capsule is thin and the skin thin patients need to consider the pros and cons of total vs partial capsulectomy). There is no evidence to support this and this is my personal approach.
Risk of BIA-ACL in implant capsule
Thank you for asking about your breast implant removal.
- Given our current understanding, BIA-ACL is related to chronic irritation from certain kinds of implants.
- Removing the implant and the capsule should remove the risk.
- The disease is so rare that we do not have data to prove this yet and never may.
- I always remove abnormal capsuiles and I always have them examined by a pathologist -
- To date, there have been no unexpected findings but there is a lot we don't know about implants, it seems a reasonable precaution -and all my patients want it done.
- But I would not consider it standard practice here or in the UK.
Always see a Board Certified Plastic Surgeon. Best wishes - Elizabeth Morgan MD PHD FAC