Breast implant surgery has been popular worldwide for decades, however, the procedure has received extra press across the past few years – and not all positive affirmations. Textured implants – the fourth generation of implants – came onto the marketplace in the late 1980s. And, whilst the use of both smooth and textured implants have dominated the breast platforms for over 30 years – it’s textured implants that have raised eyebrows and caused a stir in recent times – even prompting Allergan, global pharmaceutical company, to announce a global recall of its biocell textured implants in 2019.
What is it about textured implants that’s causing concern?
“Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is closely related to strongly textured implants, and can be avoided by using smooth devices,” says Adam Bialostocki, Da Vinci Plastic Surgery Clinic's cosmetic and reconstructive plastic surgeon.
Textured implants provide the perfect hiding spot for bacteria. Coupled with this, implants with a higher surface area may also grow bacteria quicker.
“Our advice is to stop using strongly-textured devices at the moment unless absolutely required.”
What exactly is BIA-ALCL?
It is a rare type of non-Hodgkin’s lymphoma – a cancer of the immune system cells – that develops near breast implants.
“One of the most common symptoms of BIA-ALCL is swelling – an accumulation of fluid. This can happen within a year of breast implant insertion or within 40 years,” explains Adam. “What we do know, is more uncommonly ALCL will present as a lump in the breast or under the armpit.”
According to researchers at Macquarie University's MQ Health, the mean time for developing BIA-ALCL was found to be 7.35 years. With their extensive study of Australian and New Zealand women revealing that between 2007 and 2016, of the 55 patients diagnosed with BIA-ALCL, all were exposed to textured implants. Findings also toted the risk of developing BIA-ALCL is as high 1 in 3800 implants.
So, what do breast specialists think the possible main cause of BIA-ALCL to be?
A dominant, circulating theory is that low-grade, non-clinical bacterial contamination – possibly contracted at the time of implant placement or post-operatively – could develop into BIA-ALCL over time. And, because the body cannot get rid of the implant, chronic irritation stimulates the immune system, causing the cells to transform into ALCL.
The good news for Kiwi women with textured implants?
The New Zealand Association of Plastic Surgeons continues to provide its members with the latest information about BIA-ALCL, including how to manage patients with suspected or proven BIA-ALCL.
“There have been significant changes in breast augmentation in the last five years with a change in the availability of implants and new technology such as Motiva Ergonomics implants – which we engage at Da Vinci Plastic Surgery Clinic – and fat grafting for breast augmentation,” says Adam. “We are already using best practice techniques – preventing bacteria attaching onto implants through proven surgical strategies and preventing bacterial contamination at the time the implant is placed in surgery.”
If you or someone you know is seeking guidance on breast implants, don’t wait for things to worsen, speak to a trusted professional.
