Breast Implants and Associated ALCL – Evidence-Based Data
Breast Augmentation is one of the most popular plastic surgical procedures performed in the United States, leap-frogging with Liposuction on alternate years. The story of ALCL has hit the news, causing concern in women who have implants or who are considering Breast Augmentation. Let me provide you some factual data about ALCL.
ALCL is a rare form of lymphoma that has been found in proximity to breast implants – not in breast tissue- and more specifically, textured implants, and even more specific than that, mostly the Allergan or Natrelle brand implant. ALCL presents as swelling of the implant 2-28 years after surgery. This can be worked up with an ultrasound and fluid sampling. Out of about 300,000 breast augmentations performed annually in the United States, the lifetime risk of developing ALCL is 1:30,000 to 1:50,000. (The risk of normal everyday activities like driving is much higher than this!)
If ALCL is diagnosed, treatment includes removal of the implant and surrounding “capsule,” or scar tissue the body forms around implants; and in most cases, surgery alone resolves ALCL. A multidisciplinary team would take care of a woman diagnosed with ALCL to assure she gets the most optimal treatment.
Currently due to the low risk of ALCL, Breast Augmentation is still being readily performed without any limitation, and textured implants are still utilized (I particularly like the shaped textured implants for my breast cancer reconstruction patients who need to achieve symmetry with their other breast). I currently use Mentor and Sientra products which are particularly low risk. The national plastic surgery organizations such as ASPS and ASAPS are keeping membership up to date on any new developments while working closely with the FDA.
More information can be found at www.plasticsurgery.org/alcl. I am happy to meet with women interested in Breast Augmentation and who desire a more full discussion about the surgery. It is one of the highest patient satisfaction procedures with predictable results and low risk and recovery. Please call my office if you are interested in a consultation at 410-616-3000 or check out Dr. Shermak’s blog to learn more from one of Baltimore’s top breast surgeons, MD, Dr. Michele Shermak.