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The Macro-textured Implant Recall: BIA-ALCL Risk Aversion in Cosmetic and Reconstructive Plastic Surgery Practices

Aesthet Surg J. 2022 Jun 16:sjac158. doi: 10.1093/asj/sjac158. Online ahead of print.


BACKGROUND: Since the association between anaplastic large cell lymphoma (ALCL) and textured breast implants has led to the recall of Allergan Biocell (Irvine, CA, USA) devices, plastic surgeons have been faced with the challenge of caring for patients with these implants in situ. Cosmetic and reconstructive surgeons have been contacting patients with these implants in order to encourage them to follow up and discuss the most appropriate risk reduction strategies.

OBJECTIVES: To evaluate patient concerns about the risk of breast implant associated ALCL and compare management differences between cosmetic and reconstruction patients.

METHODS: A retrospective review was performed of 432 patients with macro textured implants that presented to clinic after being contacted (121 reconstructive and 311 cosmetic). These records were analyzed for their presenting concerns, surgery wait times and management plans. Statistical analysis was performed to compare the cohorts and odds ratios were computed to determine the association between patient concerns and their choice of management.

RESULTS: After consultation, 59.5% of the reconstruction cohort and 49.5% of the cosmetic cohort scheduled implant removal or exchange. The reconstructive population had a higher rate of ALCL concern (62.7%), however both cohorts had a significant odds ratio demonstrating an expressed fear of ALCL likely contributed to their subsequent clinical management (1.66 OR cosmetic, 2.17 OR reconstructive).

CONCLUSIONS: Although the risk of ALCL appears to be more concerning to the reconstructive population, both cohorts were equally motivated to have their implants removed. Informing patients about their ALCL risk is crucial to ensure a patient supported risk reduction plan.

PMID:35709374 | DOI:10.1093/asj/sjac158

By Nevin Manimala

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