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Breast Implants – The New Ticking Time Bomb?

Thursday, June 1, 2017

The Truth about Breast Implants

A recent story on 9 News reported on the latest findings regarding Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA – ALCL).  This refers to a lymphoma (which is a cancer of the immune system) that develops in the capsule surrounding textured breast implants.  Because textured breast implants have been widely used in Australia we have what is known as a “cluster” of cases.  In fact, there have been 60 cases of BIA – ALCL diagnosed in Australia to date.  Patients with textured implants manufactured by Allegan or Silimed seem to be particularly at risk.  The disease has not been associated with smooth-walled breast implants.

When first discovered the risk was estimated at 1:1000000, then a year later at 1:100.000 and now it is estimated as “less than 1:1000 patients”.

For patients with textured breast implants manufactured by Allegan or Silimed the risk increases with time so we can expect to see many more cases in the future.

Despite the risk of this disease being relatively “small”, last year at a meeting of the American Society of Aesthetic Plastic Surgeons 90% of surgeons said that they would no longer recommend textured breast implants.

Textured implants were originally marketed as having advantages over smooth-walled implants – however these advantages have not been proven in clinical practice.  They were originally developed for placement in front of the pectoral muscles but this is rarely performed as when a surgeon places a smooth-walled implant behind the muscle the results are excellent, the risk of capsular contracture is extremely small and the risk of ALCL can be avoided.

So it is clear to me that for women desiring a breast implant for breast augmentation, then the use of a smooth-walled implant behind the muscle is the best way to minimise risk.

A further way to minimise risk is to choose a saline implant over a silicone implant.  The breast implant manufacturers state that “breast implants are not lifetime devices”.  This means that they can be expected to leak at some point in the future.  When a silicone implant leaks the silicone can travel to the lymph glands and other parts of the body.  When a saline implant leaks then the salt water is easily absorbed and there are no consequences.  The saline implant can easily be removed and replaced whereas when a silicone implant leaks it is often not possible to remove all of the leaked silicone.

Of course by far the best way to perform breast augmentation is to use your own fat – ‘breast augmentation with fat transfer’.  This is also called ‘autologous fat transfer’ and many women are now choosing this in preference to having breast implants.  With appropriate technique, it is not unusual for a 100% of the transferred fat to survive and to be incorporated into the breasts as normal fatty tissue.  Obviously the volume of increase depends on the amount of fat available for transfer but many women are happy with a more modest increase in breast volume that is completely soft, natural and free from the risks associated with breast implants.

To learn more about this procedure click here.

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