Miguel Bronchud: Breast Implants – Is There More Evidence of Health Risks and Associated Concerns?

Miguel Bronchud, Co-Founder and Advisory Board at Regenerative Medicine Solutions, shared on LinkedIn:

“Breast implants – more evidence for health risks and associated concerns?

What about a radically new approach- breast regeneration and bioengineering- based reconstructive 3D?

Breast implant illness (BII) is a term originally popularized by social media to describe ‘systemic symptoms that patients ascribe to their breast implants’. Though the concept of implants as an underlying cause for a systemic illness remains controversial, several studies have delineated the implant characteristics, capsular histology, and outcomes of patients who undergo explantation for BII.

In 2021, in a large cohort of BII patients, Katsnelson JY et al found that capsular inflammation is significantly associated with silicone and textured implants. Implant removal with capsulectomy can be safely performed in patients with BII with a low complication rate and high patient satisfaction.

Title: Outcomes of Implant Removal and Capsulectomy for Breast Implant Illness in 248 Patients

Authors: Jacob Y Katsnelson, Joseph R Spaniol, Joshua C Buinewicz, Frederick V Ramsey, Brian R Buinewicz

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Katsnelson JY, Spaniol JR, Buinewicz JC et al . Outcomes of Implant Removal and Capsulectomy for Breast Implant Illness in 248 Patients. Plast Reconstr Surg Glob Open. 2021 Sep 7.

A different more serious issue is the risk of high grade lymphoma (NHL): In the absence of high-quality evidence, there is a need for guidelines and multidisciplinary consensus recommendations on breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL). The purpose of this 2024 expert consensus conference was to evaluate the existing evidence regarding the diagnosis and management of BIA-ALCL caused by textured implants.

Title: American Association of Plastic Surgeons Consensus on Breast Implant–Associated Anaplastic Large-Cell Lymphoma

Authors: Clemens MW, Myckatyn TM, Di Napoli A, Feldman AL, Jaffe ES, Haymaker CL, Horwitz SM, Hunt KK, Kadin ME, McCarthy CM, Miranda RN, Prince HM, Santanelli di Pompeo F, Holmes SD, Phillips LG

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This comprehensive search was conducted in the MEDLINE, Cochrane Library, and Embase databases, and supplemented by manual searches of relevant English-language articles and ‘related articles’ sections.

Studies focusing on breast surgery and lymphoma associated with breast implants were included for analysis. Meta-analyses were performed and reviewed by experts selected by the American Association of Plastic Surgeons using a Delphi consensus method.

Results: A total of 840 articles published between January of 2011 and January of 2023 were initially identified and screened. The full text of 188 articles was assessed. An additional 43 articles were excluded for focus, and 145 articles were included in the synthesis of results, with 105 of them being case reports or case series. The analysis encompassed a comprehensive examination of the selected articles to determine the incidence, risk factors, clinical presentation, diagnostic approaches, and treatment modalities related to BIA-ALCL.

American Association of Plastic Surgeons Consensus on Breast Implant-Associated Anaplastic Large-Cell Lymphoma, Mark W Clemens et al. Plast Reconstr Surg.2024.

Plastic surgeons should be aware of the elevated risks by implant surface type, implement appropriate patient surveillance, and follow the recommendations.”

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