A Q&A with UC Davis plastic surgeon Granger Wong
The FDA this week issued a voluntary recall of Allergan brand textured breast implants. We asked UC Davis plastic surgeon Granger Wong some questions about what patients should know about these textured breast implants and their potential dangers.
Q: How critical of a recall is this?
A: There have been 480 cases of Allergan breast implants linked to this rare cancer in the United States. Although that risk is 1/10 of 1 percent, that is still notable for a procedure that is elective.
Q: Are textured implants common?
A: In the U.S., about 10 percent of implants are textured. It’s not uncommon but it does not make up the majority of implants. The number of affected women is much smaller than 10 percent.
Textured breast implants were first developed to prevent scar tissue formation and to prevent rotation of the implant. But these implants also stick and buckle in an abnormal way and can cause more tissue irritation. It’s that chronic irritation that the body reacts to and develops this immune system response, which has caused lymphoma in a small number of patients.
Q: Should women with this brand of implant get theirs removed?
A: The current FDA recommendation for women who already have this textured implant is to not remove them collectively - only if they are symptomatic.
Q: What are the symptoms that women should be aware of?
A: The hallmark signs of having a problem with these implants are the development of swelling and something called seroma, which is fluid that the body produces due to the common irritation around the implant, years after having this procedure done. If a woman were to experience this several years after their surgery, it would be important for them to see their plastic surgeon for this problem.
Q: What kind of cancer is linked to this implant?
A: This cancer is a lymphoma, which is a cancer of the lymphatic system. It is not breast cancer as we typically talk about breast cancer. This is a low-grade lymphoma that usually does not require chemotherapy. Simply removing the implant and removing the scar tissue around it is usually enough to remove the lymphoma. The incidence of developing this type of lymphoma is 1/10 of 1 percent only in those patients who have textured implants, not in patients with smooth implants.
Q: What is it about this company’s design that has been linked to cancer?
A: Researchers have not been able to identify why this particular texturing process is linked to lymphoma. But we know by incidence and by reported cases that this company’s implants are six times more likely than other companies' textured implants to cause this problem in patients.
Q: If someone is considering breast implants, should this be part of their conversation with their plastic surgeon?
A: It should be part of the discussion. However, textured implants are, in general, being removed from the market so it may not even be an option to have textured implants. This product has been around for almost as long as breast implants have been around - since the 1970s. The key point is that it’s chronic irritation that leads to the lymphoma. It’s not something that occurs quickly.