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The Macrotextured Implant Recall: Breast Implant-Associated-Anaplastic Large Cell Lymphoma Risk Aversion in Cosmetic
Peter Mankowski1, Matthew Carr1, Abhiram Cherukupalli1
1University of British Columbia Department of Surgery, Division of Plastic Surgery, Vancouver General Hospital, Vancouver, BC, Canada.
Aesthetic Surgery Journal
|June 16, 2022
Summary
Patients with Allergan Biocell breast implants are concerned about anaplastic large cell lymphoma (ALCL). Both cosmetic and reconstructive patients opted for implant removal or exchange due to ALCL fears.
Area of Science:
- Plastic Surgery
- Oncology
- Medical Device Safety
Background:
- Allergan Biocell macrotextured breast implants were recalled due to association with anaplastic large cell lymphoma (ALCL).
- Plastic surgeons are managing patients with these implants in situ, offering risk-reduction strategies.
- Patient follow-up and discussion of management options are critical.
Purpose of the Study:
- To evaluate patient concerns regarding breast implant-associated ALCL (BIA-ALCL).
- To compare management differences between cosmetic and reconstructive surgery patients with macrotextured implants.
- To assess the impact of ALCL risk perception on patient management decisions.
Main Methods:
- Retrospective review of 432 patients with macrotextured implants.
- Analysis of presenting concerns, wait times, and management plans.
- Statistical comparison of cosmetic and reconstructive cohorts, including odds ratios (ORs) for ALCL concern and management choice.
Main Results:
- 59.5% of reconstructive and 49.5% of cosmetic patients scheduled implant removal or exchange.
- Reconstructive patients showed a higher rate of ALCL concern (62.7%).
- Expressed fear of ALCL significantly influenced management in both cosmetic (OR=1.66) and reconstructive (OR=2.17) cohorts.
Conclusions:
- While ALCL risk is more concerning to reconstructive patients, both groups showed equal motivation for implant removal.
- Informing patients about ALCL risk is essential for developing patient-centered risk reduction plans.
- Effective communication regarding implant risks is key for patient management and decision-making.
