ALCL & BII
ALCL & BII
Breast Implant Association –
Anaplastic Large Cell Lymphoma (BIA-ALCL)
Around 2015, it became clear from several scientific articles that a white blood cell malignancy was being recognised around some breast implants.
This condition has since been termed Breast Implant Associated – Anaplastic Large Cell Lymphoma or BIA-ALCL. We now understand a great deal more about this condition which is related to some textured breast implants.
In the data collected so far, it appears that not all breast implant textured surfaces act in the same way and over 90% of the Worldwide cases of ALCL have occurred in the presence of a textured surface called Biocell.
This surface has been used by an implant company called Allergan. These implants have now been taken off the market but not recalled from patients because it is thought that the surgery to remove them has greater risk than leaving them in. That’s because the rate of ALCL is probably around 1 in 3000 Biocell textured Allergan implants inserted. Other textured surfaces have a much lower rate of something like 1 in 30,000 to 50,000 implants inserted.
The treatment of ALCL is usually thorough investigation with detailed imaging and assessment within a cancer unit.
It usually involves the removal of the implant and capsule together, this is known as an ‘en bloc excision’. There is usually no need for any additional oncology management, although new immunotherapy treatments have been developed.
Breast Implant Illness
Breast Implant Illness or BII is a description for many varied body or systemic symptoms that patients put down to their breast implants. These symptoms include things like brain fuzz, excessive tiredness, hair loss, muscle aches or joint pains.
Although theories exist linking silicone, heavy metals in breast implants or bacterial contamination of the implant surface, so far there is no known scientific link between breast implants and these problems.
Hence BII is not an actual medical diagnosis. That said, many plastic surgeon including Mr Harris, have seen these symptoms getting better if the breast implants are removed.
A lot of research is underway to find out the cause of these problems in patients and to agree on the best treatments.
Many patients believe that the problem comes from the capsular scar tissue that the body creates around implants. For this reason, they request an ‘en bloc excision’ of the implant and the capsule together, in a similar way to treating BIA-ALCL. However, this is quite aggressive and damaging surgery so patients need to fully understand the consequences of their request, which can be based on bad information from the internet.
It’s vitally important that if any patient feels that they have BII, then they should seek the advice of an expert surgeon who deals with such patients regularly but doesn’t prey on their worries and rush to very aggressive surgery in all cases.
It’s essential to state here that Mr Harris has a professional relationship with an implant company called Mentor who are owned by Johnson & Johnson, the biggest healthcare device company in the World. He provides some of the educational output for other surgeons around the World and is paid to do this on an hourly rate. He does not have any other relationship or benefit such as share deals and does not get paid to use their implants.
Hence, he is a completely independent plastic surgeon who acts in the best interests of his patients and never implant companies.
