Breast implants have been in the news lately and many women who have implants or are considering getting implants have a ton of questions. What is the real story with breast implants? There are a number of issues that are getting mixed together.If you have made it this far- you can see that there are a lot of different questions about implants. However- breast implants are probably the most studied implantable medical device out there, and for the majority of patients they are very safe and the best way to improve the appearance of the breast, whether for cosmetic reasons or reconstruction for breast cancer. If you are confused, you are not alone. There is a lot of information to process and the best way to get answers to your questions is to see your plastic surgeon. I recommend that all of my patients with implants come in for a checkup once a year to make sure they are not having any problems.
Silicone breast implants were withdrawn from the U.S. market for cosmetic purposes in 1992 due to concerns that they caused auto-immune diseases. However, extensive studies of large groups of patients showed that the rates of auto-immune disease were the same in women who had silicone implants and who did not have implants. Silicone implants were then reapproved by the FDA in 2006 and have been the most popular type of implant since then due to a more natural feel. We do not think that silicone implants cause auto immune disease or breast cancer.
A separate issue is that more recently, a very rare type of lymphoma called BIA-ALCL, short for breast implant associated anaplastic large cell lymphoma, has been found to be linked to breast implants. However, almost all of the cases were linked to textured breast implants, which means the outer surface of the implant is rough. This is why Allergan, one of the implant manufacturers, has decided to stop selling their textured implants. Even if you have an Allergan textured implant, your chance of having a problem is still extremely low, so there is no recommendation to remove the implants if you do not have anything wrong with them. Signs of a problem include new swelling, new pain or other changes in the breast. If you have any symptoms, you should see your plastic surgeon right away to have them evaluated.
How do you know if you have a textured implant? If you still have the card from your implant surgery, it will be easy to check- here is the link to the list of Allergan textured implants.
If you have textured Allergan implants and decide you would like to have them replaced with smooth implants, Allergan will provide smooth implants to you at no cost through July 24, 2021, however they will not cover the other costs of surgery such as the surgeon, facility or anesthesia fee.
While BIA-ALCL is very rare, a more common problem with silicone implants is that they have ruptured. Most implants will rupture at some point between 10 and 20 years after they are placed, although it can happen sooner. Signs of rupture include change in the shape of the implant, firmness and burning sensations. If you have any of these symptoms you should see your plastic surgeon. The best test to see if implants have ruptured is an MRI, which is recommended at 3 years after implant placement and then every other year afterwards. However, these tests are usually not covered by insurance. Implants can also just be replaced around the 10 year mark- it is much easier to switch them out before they are ruptured. If your silicone implants are ruptured, we recommend that you have them removed. Saline implants do not need to be checked for rupture, they will just deflate and your body will absorb the water if they rupture.
The final question about breast implants is something called breast implant illness. We do not have a lot of information about this process. Some women with implants report symptoms like joint pain, fatigue, problems sleeping, poor memory, rash, hair loss, headaches and other problems. Many of these symptoms are pretty common and can be caused by something other than breast implants. We don’t have any test to find out whether someone has breast implant illness. The implants and scar tissue around them can be removed through surgery, however, only some people who have their implants removed feel better.