What's BIA-ALCL?

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What is BIA-ALCL?

We love acronyms just as much as the next person, but BIA-ALCL doesn’t sound as fun as “TGIF.” So what is it?

BIA-ALCL stands for breast implant-associated anaplastic large cell lymphoma.

It’s a rare and highly treatable type of lymphoma associated with textured breast implants (learn more about textured implants in the Bustmob Academy app). 

Take some peace in knowing BIA-ALCL is extremely rare and treatments are almost always successful. But it’s important to have all the information so let’s get into the weeds a bit. 

Down the rabbit hole, we go.

TBH, we are all learning about BIA-ALCL, board-certified plastic surgeons, oncologists, and physicians included.

The first confirmed case was in 1997, so it is still pretty fresh on the medical scene. 

But here is a bit of what we know so far: 

  1. To date, BIA-ALCL appears to have a link to one specific type of textured breast implant. 
  2. The estimated risk is between 1/2000 and 1/40000.
  3. Of the millions of people with breast implants, to date there are only around 1,300 reported cases in total worldwide. 

In the United States, the vast majority of women having breast augmentation surgery for cosmetic reasons reach for a smooth breast implant. However, because the risk is so low for BIA-ALCL, some women still opt for a textured implant.

BIA-ALCL breast image
Photo by The American Society of Plastic Surgeons*

Should I be worried? 

If you’ve only had or plan to have smooth breast implants, it’s probably safe to put this concern to bed since it has never been clearly linked to the smooth implant patient population. 

As of today, BIA-ALCL has only been found in those who have or have had textured implants or in people who don't have the details of their prior surgery. There have been a few scattered deaths. However, the majority of the cases are highly treatable. 

There does seem to be a link between BIA-ALCL and women who have predetermined breast cancer risk factors through a gene called BRCA1 or BRCA2. The increased risk of breast implant-associated ALCL appears to be about 5 times more common in these women.

The risk of developing BIA-ALCL is somewhere between 1/2000 and 1/40000. The reason physicians have a hard time getting an exact number is that, although we know the number of cases, it isn’t known exactly how many patients with textured implants there are out in the world.

TBT to your math class, we have the numerator, we don’t have the denominator. 

There are different brands with different risks.

Different manufacturers also have different risks because the outside of the implant, what actually makes it textured is different–it’s a proprietary thing. You can learn more about implant brands in the free Bustmob Academy app

Among textured implants, a particular type of textured implant called BioCell is the most commonly associated with BIA-ALCL. BioCell may interact with the body differently than most textured implants and this difference may be part of the cause.

Working alongside your plastic surgeon, you’ll be able to understand more about your specific risks based on your medical history and what implant surfaces your body has seen. Doing your research beforehand can help you be prepared and empowered during your consultation. 

So…never get a textured implant, right?

At this point, the answer is maybe. Because textured implants have a lower risk of capsular contracture, they can actually be a better option for those who have had or are at risk for capsular contracture. 

However, this would be a highly selective process paired with an honest conversation with your surgeon about your medical history, your anatomy, and the risks and benefits involved. 

You can learn more about capsular contracture in the breast augmentation risk series in the free Bustmob Academy app

How do I know what type of implants I have?

When you get implants, your plastic surgeon’s office will typically give you a card that has the implant’s information on it. 

Card? What card? We get it. Things get lost. 

If you had your breast augmentation at Amelia Aesthetics, they likely have this information. Just give them the approximate date of your surgery, and they’ll look into it for you.

What if I have textured implants?

The recommendations of the American Society of Plastic Surgeons, the Food and Drug Administration, and the Surgeons of Amelia Aesthetics are to remove textured implants only if they are problematic and to avoid removing them if there are no symptoms or issues. 

BIA-ALCL is very rare, and treatment protocols are overwhelmingly successful.

In other words, from what we know now, patients accept a greater risk from an explant/ breast implant removal surgery than they do from living with textured implants.

How will I know if I have BIA-ALCL?

The most common symptom is fluid collection surrounding the implant, also known as a seroma, causing the affected breast to increase significantly in size. 

This typically happens 5-8 years after the surgery and no earlier than 6 weeks after surgery. Other symptoms include a mass, rash, or breast pain.

Testing & Treatment

When testing for BIA-ALCL, your physician will draw some of that fluid around the implant and test for abnormal cells. 

For treatment, your plastic surgeon, potentially along with a surgical oncologist, will remove the implant and all of the scar tissue around the implant.

Consultations and community answer questions.

Still feeling a little unsure? Don’t be afraid to chat with your plastic surgeon about your specific risks and concerns and connect with other women in the Bustmob Community that have had or undergoing plastic surgery. 

Our supportive, free, private community was built strictly for women to have a safe space to connect, learn, and share their plastic surgery journeys. With over 50,000 members, there is no shortage of LYLAS, helpful tips, and insight.

Now that you know the basics, you can be ready to ask your surgeon informed (maybe even some TMI questions if you really want to get nerdy) so you can make the best decision for you. 

Found this helpful, but want more? 

Good news! This is just one of hundreds of fun, factual videos on the Bustmob Academy app to make your plastic surgery research easy.

From commonly told myths and FAQs, to recovery time and costs, Jenny Eden, founder of Bustmob, and Gretta Nance, lead educator at Amelia Aesthetics, break down your plastic surgery research into bite-size, binge-able pieces. 

Pair the Bustmob Academy app with Jenny’s 15-Day Texting Series and you are well on your way to being empowered and educated before you even set foot in your consultation.

*digital image, American Society of Plastic Surgeons, accessed 14 April 2023, <ttps://www.plasticsurgery.org/patient-safety/breast-implant-safety/bia-alcl-summary>

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Gretta Nance
Lead Educator, Amelia Aesthetics
Dr. Michelle Roughton
Board-Certified Plastic Surgeon
Ready to learn everything about plastic surgery?
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