Breast augmentation consistently ranks among the most performed cosmetic surgeries worldwide. The vast majority of patients who have this elective surgery have problem-free procedures which also produce outstanding results, often surpassing the client’s expectations. The popularity of these procedures is no surprise. Few aspects of a woman’s body convey her femininity and sense of identity as her breasts, and breast augmentations have been performed by surgeons for decades, making them among the most well-understood cosmetic procedures offered.
While the popularity of these procedures continues to grow, so too, do reports of symptoms by women who have had breast implant surgery. Symptoms associated with “breast implant illness,” as it has been called, have raised concerns about the safety of certain types of implants, causing women to wonder whether they should delay a planned procedure or consider breast implant removal if they have already had one. The most pressing concern among women are reports of a rare type of cancer (called anaplastic large cell lymphoma, or ALCL) associated with textured breast implants.
While the relationship between silicone breast implants and ALCL is becoming better understood, we have yet to fully predict who is most at risk and what specific risk factors foretell who will develop the disease. There are some things we do know. ALCL is associated with textured implants and almost exclusively with a particular type of texturing used a one of the three breast implant manufacturers in the United States. As new information becomes available, one of the most important things both surgeons and patients can do in responding to these concerns is to examine the facts and case study evidence carefully rather than allowing fear or misinformation to drive their decision making. By doing so, patients, guided by their surgeons, can make informed decisions which will best suit their circumstances, preserve their safety and achieve their desired outcomes today.
Breast implant illness is a broad term which refers to a number of individual illnesses that women believe are associated with their breast implants. Illnesses which are frequently categorized underneath this blanket term include:
- Anaplastic large cell lymphoma (ALCL) — a rare cancer of immune system cells
- Capsular contracture — firm scar tissue which forms around an implant after breast pocket placement
- Chronic fatigue syndrome
- Cognitive issues
- Muscle pain around the implants
It is believed that breast implants may contribute to or cause these illnesses through a number of pathways which include:
- Breast implant breakage or rupture
- Breast implant micro-leakage (release of small amounts of silicone outside the shell)
- Silicone leakage to the lymphatic system
While the symptoms that women report are real and should be taken seriously by their doctors, the presence of symptoms in women who have breast implants does not necessarily prove or establish a link between these symptoms and the implants themselves.
Among the most concerning of the illnesses potentially associated with breast implants is ALCL, or anaplastic large cell lymphoma. ALCL is a rare form of cancer that affects the cells of the immune system; however, this cancer is not a form of breast cancer since it does not affect breast tissues even though it forms near breast implants. The most common finding in a woman who has ALCL is the development of a seroma, a pocket of clear fluid which has formed between the implant and the scar tissue surrounding the implant. However, the disease can present with a lump in the breast. Symptoms like these do not confirm an ALCL diagnosis, however; any changes in the size of your breasts or the development of a lump should always be reported to your surgeon.
The factor common to all ALCL diagnoses to date is the use of texture breast implants, regardless of whether those shells are filled with a saline solution or silicone gel. Two encouraging facts: if a woman has her textured implants replaced with smooth implants, the risks for ALCL can be significantly reduced or even eliminated. Second, for women who have had a breast augmentation using textured implants, there is no need for action unless there are problems; and if ALCL is diagnosed, it is typically highly treatable through surgery alone if caught early.
Today, the FDA recognizes the need for more research to vet these claims before conclusions can be drawn and recommendations to women can be made with confidence. As recently as March 2019, the FDA has said that it is too soon to ban silicone breasts implants which may have a link to ALCL due to a lack of scientific, independently-verified information. At the same time, the FDA has issued warning letters to two major breast implant manufacturers for “failure to comply with their requirements, under their premarket approval orders, to conduct post-approval studies to assess the long-term safety and risks of their silicone gel-filled breast implants.” These studies, which manufacturers must undertake to be in regulatory compliance, should soon provide additional, valuable information which can be used to assess the safety of saline breast implants and the course women interested in having them should take. Meanwhile, patients should rely on the expertise and experiences of their surgeons to guide them through their decision-making.
The decision whether or not to have breast augmentation can be a daunting one for many women because of the number of choices presented to a woman considering the procedure. The potential risks of breast augmentation further complicate this choice, but these factors should not deter women considering surgery from having a consultation or their procedure. The bottom line is that the vast majority of surgeries pose minimal risk, and these risks can be further lowered through strategic choices which can be made in consultation with their surgeon. The high-quality results that most women enjoy also have a priceless effect on their sense-of-self and confidence.
If you still have questions about having a breast augmentation or the safety of the procedure, schedule an in-person consultation with Dr. Andrews in Cedar Rapids and Coralville, Iowa today by calling 319-800-6877. If you are anxious about scheduling a consultation or looking for a trusted expert to answer your questions in a low-pressure environment, Dr. Andrews hosts complimentary breast augmentation seminars at his Coralville office. Stay tuned for the latest dates. We look forward to answering all of your questions and are committed to helping women achieve their ideal outcome safely.