Textured Breast Implants: Questions For Your Doctor

Textured breast implants are a popular option among doctors and patients, due to a decreased risk of scarring and of shifting position in the body. However, some textured breast implants have recently been recalled due to an increased risk of cancer. It is important to talk with your doctor to understand your risk.

What Are Textured Breast Implants?

Textured breast implants are a special line of implants that are frequently used over traditional implants.

Reasons doctors may choose to use textured implants include: 

  • They have a reduced risk of scarring.
  • They hold their position better.
  • They may be a better fit for patients who have had mastectomies.

As explained by a doctor familiar with the implants, “your tissue grows into the texturing, and that allows the implant to not rotate or flip.”

However, textured breast implants have recently come under scrutiny. The Food and Drug Administration (FDA) announced that the risk of a rare cancer called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is higher with textured breast implants than it is with smooth surface implants.

In July 2019, a pharmaceutical company that makes textured breast implants issued a global recall. The recall came after the FDA requested the company voluntarily pull the implants from the market.

What Is the Difference Between Smooth and Textured Breast Implants?

Smooth breast implants are described by plastic surgeons as being the softest feeling. They can move within the breast implant pouch, which may provide more natural movement.

On the other hand, textured breast implants cause scar tissue to develop and stick to the implant, which makes them less likely to move and shift position.

Silicone gel-filled and saline implants can be smooth or textured because the texturing is on the surface of the implant, regardless of what the implant is filled with.

How Do I Know if I Have Textured Breast Implants?

Many women have found themselves wondering if they have textured breast implants.

The FDA regulates and monitors all implanted devices. You likely received a patient device card which includes the manufacturer, a unique identifier, and a model name.

However, the best way to find out if you have textured breast implants may be to contact the plastic surgeon who performed your surgery. This will also allow you to talk with your doctor about associated risks.

What Are the Risks of Textured Breast Implants?

The FDA cautions that women with breast implants have a very low, yet increased risk of developing certain cancers compared to women who do not have breast implants.

The organization further warns that certain textured breast implants have six times the risk than other types.

Textured Breast Implant Cancer (BIA-ALCL)

BIA-ALCL is a type of non-Hodgkin’s lymphoma (cancer of the immune system) and is most commonly found in the scar tissue and fluid near the breast implant. It can sometimes spread throughout the body.

The risk of BIA-ALCL is considered low, but the cancer is serious and can be deadly, especially if it is not promptly treated. Surgery can usually successfully treat the cancer by removing the implant and scar tissue. Radiation or chemotherapy can also be successful treatment options.

Breast Implant Illness

Since the 1960s, there has been a link between breast implants and systemic symptoms. While there has yet to be concrete evidence of breast implants directly causing systemic illnesses, the issue is ongoing to this day.

Due to patient reports of symptoms, the condition has been labeled “breast implant illness.” The rise of social media has caused increased awareness, and plastic surgeons consistently receive reports from sufferers.

Other Risks

Breast implant surgery comes with some additional risks, which may include:

  • Need for additional surgeries
  • Capsular contracture (scar tissue that squeezes the implant)
  • Breast pain
  • Rupture (tears or holes) of saline and silicone gel-filled implants
    • Deflation with noticeable change to breast size
    • Silent (without symptoms) rupture of silicone gel-filled implants
  • Infection

What Breast Implants Have Been Recalled?

The FDA issued a Class 1 recall of certain implants. Class 1 is considered the most serious type of recall, as it is associated with the risk of serious injury or death.

All lot numbers for the following products (distributed between September 14, 2014 and July 24, 2019) have been recalled: 

  • Allergan Natrelle BIOCELL Textured Products:
    • Allergan Natrelle Saline-Filled Textured Breast Implants
    • Allergan Natrelle Silicone-Filled Textured Breast Implants
    • Allergan Natrelle® 410 Highly Cohesive Anatomically Shaped Silicone- Filled Textured Breast Implants
    • Allergan Natrelle 133 Plus Tissue Expander
    • Allergan Natrelle 133 Tissue Expander with Suture Tabs

Other companies, such as Mentor and Sientra, have not issued recalls but make implants also linked to BIA-ALCL.

What Is Breast Explant Surgery?

Breast explant surgery is surgery to remove breast implants and the scar tissue that has formed around them.

For patients who have textured breast implants but are not showing symptoms, the FDA does not recommend removing the implants. Rather the agency recommends that patients know the symptoms of BIA-ALCL.

Some symptoms of BIA-ALCL include: 

  • Persistent swelling
  • Presence of a mass
  • Pain near the breast implant

All breast implant patients are encouraged to closely monitor the area around their implants for any changes.

Educate Yourself About the Risks of Breast Implant Cancer

Breast implants come with certain risks. For anyone considering them, it is important to understand the possibility of an increased risk of cancer.

Some other important factors to consider include:

  • Implants are not lifetime devices, and it is likely they will need to be removed.
  • The cost of removal or replacement may not be covered by insurance.
  • The longer breast implants are in, the more likely complications are.

Until the health risks associated with textured breast implants are fully known, it is recommended that breast implant candidates not choose this type of implant.

Sources: 

American Cancer Society. (July 25, 2019). “Breast Implant Recall: What You Need to Know.” Retrieved from https://www.cancer.org/latest-news/breast-implant-recall-what-you-need-to-know.html. Accessed on December 15, 2019.

American Society of Plastic Surgeons. “Breast Augmentation.” Retrieved from https://www.plasticsurgery.org/cosmetic-procedures/breast-augmentation/implants. Accessed on December 15, 2019.

Breastcancer.org. “FDA Updates Warning on Link Between Textured Breast Implants and Rare Cancer.” Retrieved from https://www.breastcancer.org/research-news/fda-updates-on-textured-implants-and-cancer. Accessed on December 15, 2019.

CBS News. (July 25, 2019). “Textured breast implant recipient on cancer diagnosis: It was “total shock”.” Retrieved from https://www.cbsnews.com/news/allergan-recall-textured-breast-implant-recipient-on-cancer-diagnosis-total-shock/. Accessed on December 15, 2019.

Journal of the American Society of Plastic Surgeons. (March 2019). “Breast Plant Illness: A Way Forward.” Retrieved from https://journals.lww.com/plasreconsurg/Fulltext/2019/03001/Breast_Implant_Illness__A_Way_Forward.12.aspx. Accessed on December 15, 2019.

U.S. Food & Drug Administration. “Questions and Answers about Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).” Retrieved from https://www.fda.gov/medical-devices/breast-implants/questions-and-answers-about-breast-implant-associated-anaplastic-large-cell-lymphoma-bia-alcl. Accessed on December 15, 2019.

TMC News. (July 26, 2019). “Textured breast implants associated with rare cancer pulled from shelves.” Retrieved from https://www.tmc.edu/news/2019/07/textured-breast-implants-associated-with-rare-cancer-pulled-from-shelves/. Accessed on December 15, 2019.