Long-Term Safety of Textured and Smooth Breast Implants Reviewed

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A review and comparison of breast implant options, as well as the evolution of implant surface textures, long term safety data, and perspectives on Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) are explored by Grant Stevens, MD, FACS, et al., in a recent article in the Aesthetic Surgery Journal.

Breast augmentation is one of the most common aesthetic operations performed in the U.S., with a 207 percent increase since 1997, according to the American Society of Aesthetic Plastic Surgery (ASAPS). The evolution of breast implant technology has led to continuous improvement in patient outcomes.

“The reason that we conducted and published this review was to describe implant options and to stress the importance of maintaining these options. This allows surgeons to weigh the benefits and risks of their choices, thus providing the best-individualized outcome for each patient,” Dr. Stevens said.

For example, FDA requirements led to five important 10-year Core studies that consistently demonstrated the long-term safety of silicone gel breast implants. (Core studies assess long-term clinical performance.) Further, the experience of plastic surgeons outside the U.S., the availability of shaped implants within the U.S. and 10-year core data all provided evidence that the textured implant may offer more optimal outcomes in certain types of breast surgeries, both aesthetic and reconstructive.

“We found that the stability of textured implants in the breast pocket may support better outcomes in patients with chest wall abnormalities, revisional breast cases, poor soft tissue cases, including mastopexies, and may reduce the risk for capsular contracture in all cases,” Stevens said. He added that this correlates with certain texture types.

The concern for the rare occurrence of BIA-ALCL has recently overshadowed the ability to have a fair and comprehensive discussion about textured implants. “BIA-ALCL research will continue, and current theories and numbers will evolve accordingly,” Stevens said. “Physicians must thoroughly obtain consent from patients, uphold surgical best practices and promote awareness of symptoms and treatments, as early diagnosis is the key to the best outcome.”

The most common symptom of BIA-ALCL is persistent swelling of the breast and/or a lump in the breast or armpit. Symptoms typically develop between three and 14 years after the insertion of breast implants and most frequently around eight years.

Dr. Stevens is the founder and medical director of Marina Plastic Surgery. He is a board-certified Diplomate of the American Board of Plastic Surgery, a Fellow of the American College of Surgeons and the International College of Surgeons. He is Chairman of the USC-Marina Aesthetic Surgery Fellowship, Director of the USC Division of Aesthetic Surgery and a Clinical Professor of Surgery at the USC Keck School of Medicine. Dr. Stevens serves on the Board of Directors as president-elect of ASAPS, as well as the third vice president of the International Society of Aesthetic Plastic Surgery where he serves as one of the traveling professors. He has spoken at more than 100 meetings and 300 invited talks nationally and internationally.

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