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Breast augmentation is the most popular cosmetic procedure for women worldwide. The procedure is safe and straightforward with a long history of success and patient satisfaction, and breast implants are the most studied devices in medicine. However, despite the procedure’s popularity and excellent track record of performance, misinformation about breast implants and breast augmentation continues to circulate.

Discussion is growing about a rare type of non-Hodgkin lymphoma called anaplastic large cell lymphoma (ALCL) that may be linked to textured breast implants. Patient safety is a priority at Banff Plastic Surgery and all efforts are made to reduce the likelihood of complications developing. Though ALCL is rare, it’s important for patients to be informed about all risks and benefits associated with breast augmentation.

What Is ALCL?

Anaplastic large cell lymphoma is a cancer of the cells of the immune system and it is not a breast cancer. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a specific form that develops near breast implants. The primary symptoms of BIA-ALCL are persistent swelling or a lump in the vicinity of the implant. The swelling is caused when a pocket of clear fluid called a seroma develops between the implant and the surrounding fibrous scar capsule. Having one or more of these symptoms does not necessarily mean a BIA-ALCL diagnosis.

Can BIA-ALCL Be Treated?

When identified in a timely manner, BIA-ALCL is almost always treatable (now that the issue is better understood) with capsule removal. The affected cells are confined to the seroma fluid in most cases and do not invade the capsule, allowing for conservative surgical treatment rather than chemotherapy. Complete surgical excision of the lymphoma, implant and surrounding fibrous capsule offers most patients a good prognosis for recovery. New, smooth, implants can still be used even when BIA-ALCL has been diagnosed and treated.

Who Is at Risk of Developing BIA-ALCL?

The type of surgery (cosmetic augmentation or breast reconstruction) does not appear to be a risk factor for BIA-ALCL, nor does the filler material (saline or silicone gel) of the implant. The texture of the implant’s outer shell, however, appears to increase the risk for some patients. Evidence suggests that the more aggressively textured implants are more likely to develop BIA-ALCL. To date, there have been no cases of BIA-ALCL associated with a smooth-walled implant when only the smooth-walled implant was used. Dr. Hall-Findlay no longer performs breast augmentation with textured implants and all of her patients who received the aggressively textured implants have been informed and encouraged to come back for assessment. All Banff Plastic Surgery patients currently receive smooth-walled silicone gel or saline implants.

For More Information

If you are considering breast augmentation, or have already undergone the procedure, you may have questions about your risk of developing BIA-ALCL. Dr. Hall-Findlay encourages all patients to return for evaluation and discussion. Choosing to obtain or remove a breast implant is a personal decision that should be made based on individual needs and with the most complete information available. Contact Banff Plastic Surgery today at 403-762-2055 to discuss your options.

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