In order to be proactive and reassure his breast reconstruction and breast augmentation patients about the recent FDA release, Board Certified Plastic Surgeon Brian S. Glatt, MD, FACS sent the following letter to his patients who have received breast implants:
I am reaching out to all of my patients who have received breast implants in an effort to enhance awareness and also provide accurate information regarding recent reports from the FDA about ALCL and its association with breast implants. While the media may present this as “new” news, it is not. I have been aware of this issue and, in fact, most of you had a section regarding the existence of ALCL in your informed consent for breast implant surgery.
ALCL is an extremely rare type of lymphoma which seems to be associated with the presence of breast implants. Breast ALCL occurs in the breast pocket itself, NOT throughout the body, and is COMPLETELY curable with removal of the breast implant and capsule. Patients with ALCL most commonly present with late onset (years after their implantation surgery) development of significant swelling and fluid collection in one breast – this would not be subtle and would be very apparent to you if it should occur. In addition, breast ALCL seems to be associated with the use of textured surface breast implants. There have been no confirmed cases of ALCL in the United States being associated with smooth walled implants. This is important because the large majority of my patients have round implants, which have a smooth wall and are NON TEXTURED. The only breast implants I use that have texturing are the “410″ or “anatomic implants” – which some of you do indeed have. In these cases, please rest assured that ALCL is such an extremely rare condition that it is not something which you should be overly concerned about. I have full confidence in the breast implants I use, which are all FDA approved devices. If you do notice anything abnormal or significant changes in one breast, please call our office for evaluation. If you would like additional information, please click on the link to ASPS- plasticsurgery.org/alcl which outlines some information and official data.
Below is a section from my breast implant informed consent, which comes from ASPS, our national society in plastic surgery:
Anaplastic Large Cell Lymphoma (ALCL):
Women with saline and silicone gel breast implants may have a very small and possibly increased risk of developing anaplastic large cell lymphoma (ALCL) in the scar capsule adjacent to the implant. This is a very rare disease and is currently being investigated as to its relationship to breast implants, and whether this is even a cancer or a Lymphoproliferative Disorder. ALCL is an extremely rare cancer of the immune system which can occur anywhere in the body. The National Cancer Institute estimated 1 in 500,000 women per year in the U.S. are diagnosed with ALCL. ALCL in the breast is even rarer with approximately 3 in 100 million women in U.S diagnosed per year. The relationship between breast implants and ALCL is unclear and is currently under investigation. In most cases, women observed changes in the look or feel of the area surrounding the implant after their initial surgical sites were fully healed.
I do not plan on any changes to my current approach to breast implant surgery, given the information presently available. I will, of course, continue to keep up with any developments in this area and keep you informed if any new information arises in the coming years. If you have any additional questions or concerns I welcome communication from you.
Brian S. Glatt, MD, FACS
Certified by the American Board of Plastic Surgery
Chief, Section of Plastic Surgery, Morristown Medical Center
Assistant Clinical Professor, Division of Plastic Surgery
Thomas Jefferson School of Medicine
Premier Plastic Surgery Center of New Jersey, LLC
310 Madison Avenue, Suite 100
Morristown, New Jersey 07960