ASK DR. BARBER

BY WILLIAM BYRON BARBER II, M.D.

Q. I have read some recent reports that the FDA is beginning to investigate the safety of breast implants.  I have had implants for 7 years and have been happy, but I do not want something in my body that can harm me.  Now I am worried and do not know what to do about the implants.  Should I have them removed?

A. First, let me say that unless you are having some problem with your breast implants the short answer is NO. The reports that you refer to are correct that the FDA is seeking information from a variety of sources to see if there is any pattern of concern relative to safety of breast implants. Of particular importance to the FDA is whether implants cause a rare form of cancer called anaplastic large cell lymphoma. This is a type of cancer that develops in the breast, that seems to be related to the textured silicone gel implant. It is not breast cancer, it is lymphoma in the breast and there is little doubt that this is a real disease that is related to textured implants. The condition was first reported in 1997 and since then more cases have been identified as plastic surgeons have learned the symptoms of the disease. If the lymphoma is discovered early enough, it is completely curable by simply removing the implants and the surrounding scar tissue around the implant. I have never seen a case of lymphoma of the breast in my 30 years of practice. Since the disease seems to be related to a particular type of implant, I have avoided the use of that implant for many years. 

The FDA is also interested in whether there is any relationship between implants and autoimmune diseases. This question has been investigated once before related to silicone implants. Silicone gel implants were removed from the market by the FDA between 1992 and 2006 in order to investigate claims by women that breast implants were making them sick. During this moratorium, many studies were performed to see if there was any relationship between silicone gel implants and autoimmune diseases. After 14 years of study, the FDA concluded that there was no evidence that pointed to the silicone gel as the culprit in causing autoimmune illnesses. Fast forward to 2019 and once again there are new claims by women that they are getting sick from their breast implants, and once again the FDA has agreed to look into these claims. It is my opinion that this is a good thing.  The safely of patients is paramount and both the patient and doctor need to be confident that implants are safe. Before getting breast implants, women deserve to know all the risks related to having implants in their body. The following is some of the advice that I give my patients before I agree to do the surgery: breast implants are not a perfect device. All breast implants will eventually need to be replaced. Complications can occur after breast augmentation including infection, bleeding, unnatural hardness, distortion of the breast, and sometimes patients just don’t like the results. Finally, I tell my patients that breast augmentation is a reversible procedure, if you are unhappy with the results or you are having problems that you believe are caused by the implants, take them out. See your plastic surgeon to discuss your concerns and come up with a plan that is best for you.

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