Textured and Smooth Breast Implants

If you have textured breast implants, you may be concerned about Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a rare form of lymphoma. This page is dedicated to providing clear information about BIA-ALCL.

I also have Allergan macro-textured implants with one of the highest links to BIA-ALCL diagnosed cases and have tried to think of all of the questions you might want answered.

Annabelle Baugh | CSA Founder

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What is BIA-ALCL?

The World Health Organisation (WHO) classified Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) as a rare and highly treatable type of non-Hodgkin’s lymphoma that can develop due to breast implants in 2016.

BIA-ALCL is not breast cancer, but a form of T-cell lymphoma that usually occurs in the fluid and scar tissue surrounding textured implants.

Who is at risk for BIA-ALCL?

Individuals with polyurethane-coated implants and textured breast implants are at risk. Both silicone and saline implants have been associated with this condition.

In response to the FDA’s request in July 2019, Allergan voluntarily withdrew the below brands of breast implants from sale.

What is the risk of BIA-ALCL with textured implants?

Although the likelihood of acquiring BIA-ALCL is still under debate, evidence from reliable resources indicates that the risk is less than 0.1%. The Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) completed the most recent investigation in 2020, and the results show that the projected lifetime incidence ranges from 1.65 to 35 instances per 100,000 *(0.00165% and 0.035%).

As of March 2024, the American Society of Plastic Surgeons (ASPS) reported that for textured implants placed during the preceding 20 years, the estimated lifetime risk of BIA-ALCL is 1:2,207-1:86,029 *(0.045% to 0.001%).

How can I find out what brand and style of implants I have?

You may have received this information on a patient device card when you had your breast augmentation. If you would like to obtain any of this information, speak with the surgeon or company that performed your breast augmentation  or request the record of your surgery (operative notes) from the facility where it was performed.

What are the symptoms of BIA-ALCL?

Symptoms of BIA-ALCL can occur quickly and typically include:

• Unusual, painless swelling in the one or both breasts
• Lumps in the breasts or armpit
• Change to skin texture, redness or rash
• Changes in the size or shape of the breasts
• Breast feel firmer indicating capsular contraction
• Breast discomfort, soreness, or pain

What should I do if I’m experiencing BIA-ALCL symptoms?

Consult your doctor  immediately and explain you have breast implants and are concerned about symptoms of BIA-ALCL. These symptoms don’t automatically mean you have BIA-ALCL, but it’s crucial to get evaluated promptly.

How is BIA-ALCL diagnosed?

Diagnosis involves a combination of physical examinations, ultrasound and, or MRI imaging tests.  A needle biopsy with fluid drainage will be required if a collection of fluid or a mass is discovered in order to test for BIA-ALCL.

Armpit lumps could indicate that BIA-ALCL has progressed to the lymph nodes or they could just be a typical lymph node enlargement. A surgical excision of a lymph node or a needle biopsy may be carried out for testing.

How is BIA-ALCL treated?

The primary treatment for BIA-ALCL is the surgical removal of the affected implant and the surrounding scar tissue capsule, this is called total or en-bloc capsulectomy.  In more advanced cases, chemotherapy and,or radiation therapy may be required.

Can BIA-ALCL be prevented?

Currently there are no known cases of BIA-ALCL in individuals who have only ever received smooth implants. However, if you have implants associated with BIA-ALCL there is no way to prevent it from occurring.

Removal of the implants with en-bloc capsulectomy is the recommended surgery to treat BIA-ALCL, however this procedure does not totally rule out the possibility of developing BIA-ALCL. The most important factor is early detection of symptoms and diagnosis of BIA-ALCL.

How long after getting textured implants can BIA-ALCL develop?

The time frame varies. Some cases develop within a few years, while others may occur a decade or more after the breast implant surgery. This highlights the importance of long term monitoring and awareness of BIA-ALCL symptoms.

If I have textured breast implants, should I have them removed?

Currently the medical regulatory bodies in the UK, US/Canada and Australia do not advise removal of textured breast implants if you are not experiencing BIA-ALCL symptoms. Factors like your implant history and overall health are crucial considerations.

Most health agencies around the world don’t recommend routine removal of implants, but rather emphasise monitoring and prompt attention to potential symptoms.

If I have my textured implants removed. What is the procedure like?

The procedure is more extensive than breast augmentation or simple breast implant removal. Because the procedure involves removing the implant and the entire surrounding scar capsule this carries additional surgical risks and a longer recovery period.

In some cases, a breast lift may be performed at the same time to improve the aesthetic outcome and help prevent seromas occuring in the gap left by the implants.

What can I expect in my recovery period after implant removal?

Recovery time varies depending on the type of procedure. Typically with a partial capsulectomy you will experience some pain for a couple of days and discomfort, swelling, and bruising which will subside within around two to four weeks.

The recovery time following an en-bloc capsulectomy will depend on various factors and should be discussed in detail with your surgeon.

If my implants are removed but no BIA-ALCL is found, is there anything further I need to do?

If BIA-ALCL is ruled out, your doctor may recommend ongoing checkups or imaging studies to monitor your breast health as deemed necessary. Be sure to discuss your continued care plan with your healthcare provider.

Can BIA-ALCL return after implant removal and treatment?

While the treatment for BIA-ALCL has a high success rate, there is a possibility of recurrence (the cancer coming back) in some cases. Your doctor will recommend follow up care and monitoring.

Can BIA-ALCL spread to other parts of the body?

In rare cases, BIA-ALCL can spread to other areas, like lymph nodes. This is why prompt diagnosis and treatment are crucial to prevent complications.

Does having a family history of cancer make me more likely to develop BIA-ALCL?

Having a family history of breast cancer or other types of lymphoma may influence your overall risk for certain cancers. However, there’s no evidence of a direct genetic link specifically to BIA-ALCL.

Does BIA-ALCL affect my ability to have children in the future?

In most cases, BIA-ALCL treatment should not directly impact your ability to have children. However, some treatment options, like certain chemotherapy drugs, can affect fertility. Consult with your doctor or a fertility specialist if this is a concern.

Will Allergan pay compensation if BIA-ALCL is diagnosed?

To claim compensation you will need to register a claim with a law firm. The warranty on specific Allergan  implants may vary, to find out more you can complete an Allergan Breast Implant Warranty Claim.  

I’m considering breast augmentation. Are smooth implants safe?

Smooth implants are considered to have no link to BIA-ALCL risk. However, many surgeons believe they have a higher associated rate of other potential complications. Ask your plastic surgeon to provide a full list of potential risks and complications associated with your specific implants.

The most critical aspect to improve your safety when undergoing breast augmentation or cosmetic breast surgery is to select a qualified plastic surgeon with good medical standing.

How can I find a qualified plastic surgeon for breast implant removal?

I set up Cosmetic Surgery Advancements with a mission to help individuals obtain the safest cosmetic surgery possible. You can discover outstanding plastic surgeons in our CSA Cosmetic Surgery Directory.

CSA plastic surgeons have undergone extensive background checks for board certification from the American Board of Plastic Surgery, The Royal College of Physicians and Surgeons of Canada, or the GMC specialist registry in the UK.

These organisations ensure that plastic surgeons are held to the highest standards, to provide you with transparent, skilled, and safe solutions for cosmetic plastic surgery.

More Information on:

Breast Implant Removal and Exchange

Breast Reconstruction Without Implants

BIA-ALCL: More Information

While BIA-ALCL is a serious concern, it’s highly treatable, especially when caught early. Knowledge is your greatest tool. Understanding your risk factors, staying vigilant about any breast changes, and regularly consulting with your healthcare provider are crucial steps in safeguarding your health.

Whether you have breast implants or are considering them, this FAQ page is just the beginning. Ongoing information and the latest research on BIA-ALCL, safety updates, and resources, are available in the CSA blog BIA-ALCL section.

If you’re a plastic surgeon committed to patient safety and want to join the CSA directory please claim your free consultant profile.

BIA-ALCL Compensation Claims

There have been various class action lawsuits filed against Allergan. The advantage is you can join a class action without paying anything. You will only pay if the case is successful, which is normally an agreed percentage of the total settlement awarded. Class actions can take decades to complete and Allergan have not settled any lawsuits to date.

Currently you can join an active lawsuit if you have had a BIA-ALCL diagnosis. Below are a few of the law firms in the UK, US, Canada and Australia that have filed class actions and are open to new plaintiffs joining.