Melbourne Plastic Surgery Blog

Melbourne Plastic Surgery Blog

Information regarding breast implant associated Anaplastic Large Cell Lymphoma

Thursday, June 28, 2018

Following renewed media interest regarding the correlation between breast implants and an increased risk of developing Non-Hodgkin’s Lymphoma Mr Mutimer thought the timing pertinent to outline key information related to BIA-ALCL.  

The following information has been sourced from the Australasian Society of Aesthetic Plastic Surgeon’s website and summarises what we know to date:

FACTS ASSOCIATED WITH BIA-ALCL

  1. It is a cancer of lymphatic cells and a form of Non-Hodgkin’s Lymphoma.
  2. It is not a breast cancer.
  3. It occurs in association with breast implants and to date exclusively with exposure to textured implants (i.e. No case has been reported with exposure to smooth implants alone).
  4. It occurs in women who have had implants for both cosmetic and reconstructive indications.
  5. It takes an average of 7-10 years after implant insertion before it develops.
  6. The commonest presentation is a fluid swelling around the breast implant and in the space between the implant and breast implant capsule – late seroma. The diagnosis of the condition is made by examination of the seroma fluid.
  7. Early stage disease is curative with surgery alone.
  8. Disease which has spread through the capsule, forming a mass or which has spread to local lymph glands carries a worse prognosis.

RISK 

The most accurate assessment of risk published to date is from a detailed study of numerator and denominator in Australia and New Zealand. This showed that the risk for implants with high surface area texture (biocell, Alllergan and polyurethane, Silimed) were around 10 times higher (1 in 4,000 to 1 in 7,000) compared with implants with lower surface area texture (1 in 60000 for siltex Mentor). The risk was calculated only for companies that complied with a request for provision of sales data.

We did see ALCL arising from other implant manufacturers, but were not able to calculate risk due to their refusal to supply data for analysis.

The study also identified clusters of multiple cases arising from the same practice. These clusters are currently under investigation, with the consent of the centre and/or surgeon, and there is insufficient evidence presently

to comment as to likely causative factors.


CAUSATION

Recent media stories suggested that there is a link with cut-price providers. No such link that has been established to date by analysis of the evidence.

A unifying theory was proposed by the ANZ epidemiology paper and has become widely accepted worldwide as the best explanation for factors that cause BIA-ALCL.

The unifying theory cites four inter-related factors:

  1. Textured implants (with a higher risk for high surface area textures)
  2. Bacterial contamination at the time of surgery to reach a threshold to cause inflammation
  3. Patient genetic predisposition
  4. Time - for the process to develop.
Bacteria have been identified in association with these tumours, similar to the association between gastric lymphoma and Helicobacter pylori.

I'VE HAD BREAST IMPLANTS OR AM CONSIDERING SURGERY - WHAT SHOULD I DO NEXT? 

If you currently have breast implants and are concerned you should consult with a Specialist Plastic Surgeon who will determine what type of implants you have and address your concerns.

Similarly if you are considering breast implant surgery it is important to schedule a consultation with a Specialist Plastic Surgeon to discuss the risks and benefits, including the risk of BIA-ALCL. There are different types of implants available and selection needs to take into account the risks and benefits of specific choices.

For more information or to book a Consultation with Mr Keith Mutimer – Specialist Plastic Surgeon phone 03 9592 0522 or submit a confidential enquiry via our website.

 

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Information regarding breast implant associated Anaplastic Large Cell Lymphoma

Following renewed media interest regarding the ..

Read more

Following renewed media interest regarding the correlation between breast implants and an increased risk of developing Non-Hodgkin’s Lymphoma Mr Mutimer thought the timing pertinent to outline key information related to BIA-ALCL.  

The following information has been sourced from the Australasian Society of Aesthetic Plastic Surgeon’s website and summarises what we know to date:

FACTS ASSOCIATED WITH BIA-ALCL

  1. It is a cancer of lymphatic cells and a form of Non-Hodgkin’s Lymphoma.
  2. It is not a breast cancer.
  3. It occurs in association with breast implants and to date exclusively with exposure to textured implants (i.e. No case has been reported with exposure to smooth implants alone).
  4. It occurs in women who have had implants for both cosmetic and reconstructive indications.
  5. It takes an average of 7-10 years after implant insertion before it develops.
  6. The commonest presentation is a fluid swelling around the breast implant and in the space between the implant and breast implant capsule – late seroma. The diagnosis of the condition is made by examination of the seroma fluid.
  7. Early stage disease is curative with surgery alone.
  8. Disease which has spread through the capsule, forming a mass or which has spread to local lymph glands carries a worse prognosis.

RISK 

The most accurate assessment of risk published to date is from a detailed study of numerator and denominator in Australia and New Zealand. This showed that the risk for implants with high surface area texture (biocell, Alllergan and polyurethane, Silimed) were around 10 times higher (1 in 4,000 to 1 in 7,000) compared with implants with lower surface area texture (1 in 60000 for siltex Mentor). The risk was calculated only for companies that complied with a request for provision of sales data.

We did see ALCL arising from other implant manufacturers, but were not able to calculate risk due to their refusal to supply data for analysis.

The study also identified clusters of multiple cases arising from the same practice. These clusters are currently under investigation, with the consent of the centre and/or surgeon, and there is insufficient evidence presently

to comment as to likely causative factors.


CAUSATION

Recent media stories suggested that there is a link with cut-price providers. No such link that has been established to date by analysis of the evidence.

A unifying theory was proposed by the ANZ epidemiology paper and has become widely accepted worldwide as the best explanation for factors that cause BIA-ALCL.

The unifying theory cites four inter-related factors:

  1. Textured implants (with a higher risk for high surface area textures)
  2. Bacterial contamination at the time of surgery to reach a threshold to cause inflammation
  3. Patient genetic predisposition
  4. Time - for the process to develop.
Bacteria have been identified in association with these tumours, similar to the association between gastric lymphoma and Helicobacter pylori.

I'VE HAD BREAST IMPLANTS OR AM CONSIDERING SURGERY - WHAT SHOULD I DO NEXT? 

If you currently have breast implants and are concerned you should consult with a Specialist Plastic Surgeon who will determine what type of implants you have and address your concerns.

Similarly if you are considering breast implant surgery it is important to schedule a consultation with a Specialist Plastic Surgeon to discuss the risks and benefits, including the risk of BIA-ALCL. There are different types of implants available and selection needs to take into account the risks and benefits of specific choices.

For more information or to book a Consultation with Mr Keith Mutimer – Specialist Plastic Surgeon phone 03 9592 0522 or submit a confidential enquiry via our website.

 

Why Winter Is An Ideal Time To Have Plastic Surgery

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A common question posed by clients looking to undergo plastic surgery in Melbourne is “when is the best time to have this procedure?”.  Whilst timing may not be an important factor for some, and there really is no right or wrong time to schedule in your surgery, winter most definitely has its benefits.

We always recommend doing what works best for you however some considerations for why winter could be a more favourable time include:

  • A more comfortable recovery: your recovery time will be the same regardless of when you have plastic surgery however winter generally poses more favourable conditions for a comfortable recovery.  The cool weather during winter means you are more likely to be wearing bulkier clothing, making it easier to cover up any swelling, dressings or compression garments.  
  • Sweat less: you will sweat less in winter making any post-surgical dressings or garments generally more comfortable to wear.
  • Easier to avoid sun exposure: exposing scars to the sun can cause permanent damage and should be avoided at all costs. For those who have lived through (and survived) a Melbourne winter you will know that generally over-exposure to sun won’t be an issue at this time of year!
  • You won’t miss out on water activities: swimming, especially in pools, is often prohibited post-surgery so again undergoing plastic surgery in winter means you won’t be left sitting on the sidelines while others enjoy the water.
  • Not showering may be easier to manage: no one likes to think about not showering regularly, however after your procedure you may be instructed to refrain from showering for several days –generally much easier to manage in the cooler months.
  • You’ll be summer ready: opting for plastic surgery in the cooler months mean you will have recovered and be ready to put your best foot forward in summer.

If you are considering plastic surgery we recommend booking a consultation with a specialist plastic surgeon in Melbourne who will be able to discuss your intended procedure, perform a full assessment of your suitability, discuss expected outcomes and answer any questions you may have, including when may be the best time to have the procedure. 

For more information or to book a consultation feel free to call us on 03 9592 0522 or submit an enquiry via our website.

Spotlight on Breast Reduction Surgery

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Breast reduction surgery is a popular procedure amongst women who visit Brighton Plastic Surgery.  A breast reduction is an effective treatment for large, heavy and sagging breasts. It removes excess breast tissue and skin to achieve a breast size more in proportion with your body.  A breast reduction will also alleviate common complaints associated with large breasts including shoulder, neck or back pain, breast crease irritation and difficulty in finding clothing that fits comfortably.  The procedure is designed to make the breasts smaller, more shapely and better supported.

For women who have breasts far out of proportion with their body size, a breast reduction can bring about life-changing results.

Excessively large breasts can be a physical and emotional burden for many women. The reasons for wanting breast reduction surgery do vary however if you are unhappy with your large breasts and experiencing any of the below you may be considered a suitable candidate for breast reduction surgery:

  • Breasts that are not in proportion to the rest of your body
  • Frequent neck, back or shoulder pain
  • Uncomfortable grooves in your shoulder from your bra (whereby the weight of your breasts result in your bra straps being pulled down)
  • Poor posture as a result of your breast size (many women with larger breasts tend to stoop/hunch their shoulders forward in an effort to minimise the perceived size of their breasts)
  • Heavy breasts that droop, with nipples and areolas that point downwards
  • Trouble sleeping due to discomfort when lying down
  • Rashes or infections under the breasts / in the crease line
  • Generally feeling self-conscious
  • Limited capacity for physical activity

Making the decision to undergo a breast reduction is a big step.  If you would like to learn more we recommend scheduling a consultation with a qualified Plastic Surgeon.  He or she will ask questions to learn more about you and your medical history, conduct a full examination and get a thorough understanding of your specific needs and expectations.  They will then be able to explain the various treatment options available and help you determine the best approach for your specific circumstances.

If you would like to find out more about breast reduction surgery at Brighton Plastic Surgery, including estimated cost for the procedure visit our Breast Reduction Web Page.  Alternatively feel free to schedule in an obligation free consultation via our website or by phoning us on 03 9592 0522.