Breast Implant Safety

To all of my patients,

I wanted all of you to know that I am and have been following the BIA-ALCL very closely. There has been a recent recall of Allergan textured implants. While we have not used those implants in a long time, I have used them in the past. We will be contacting all of them individually. My patient’s safety is the highest concern. I also don’t want to start an unnecessary panic. Here is a little more about BIA-ALCL including some helpful links at the bottom with reputable information.

While breast implants have been studied for more than two decades and very rarely produce side effects, we wanted to make you aware of an uncommon condition called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). This condition has only been documented thus far in textured implants and is very treatable when caught early.

Symptoms of the condition may include swelling, redness, changes in firmness or lumps around one or both implant(s). If you are experiencing these or any other symptoms, please contact us for an appointment. In the vast majority of patients, these symptoms are not serious and may or may not require treatment.

Generally, it is a good idea to follow up with your plastic surgeon periodically to ensure that your implants are still intact and not producing any unwanted side effects. Mammograms will not detect these changes, only MRIs will, so we urge you to follow up with us periodically if you notice any of the above-listed side effects or are experiencing any other symptoms or discomfort.

I would like for you to call my office if you have any questions or concerns. If treated early, BIA-ALCL is almost always completely curable, but if untreated, it can be more serious.

Additionally, I want to remind you of the importance of ongoing breast health surveillance including self-breast exams and mammograms scheduled by your physician.

https://www.plasticsurgery.org/patient-safety/bia-alcl-summary

https://www.plasticsurgery.org/for-medical-professionals/health-policy/bia-alcl-physician-resources/safety-advisory

https://www.surgery.org/sites/default/files/BIA-ALCL-Talking-Points-6-24-19.pdf

https://www.plasticsurgery.org/for-medical-professionals/health-policy/bia-alcl-physician-resources

Sincerely

Malcolm Rude, M.D.

Temple Filling

Over the past few years possibly my favorite area of filling has become the temples.

The reason it is my favorite is because it is the area that I can fill with very little bruising that no one knows what I did but everyone is told that they look much better. As people age, particular by the time they hit their mid to later 40’s, their temples begin to hollow. This adds hollowness to their eyes. It is a very subtle but effective way of improving someone’s eye appearance. It can often make them look less tired.

There are a couple of different options for filler.

The best one often depends on what other areas are being addressed. Two of my favorite are Sculptra and Radiesse. The other nice thing about the temples is that we can simulate what the appearance change will be like by injecting saline. This allows the patient to “try it on”.

Implant Types

Breast Implant Types

There are several different types of breast implants. Implants can be differentiated on a couple of different levels. The first most obvious level is their content. Breast implants can either be filled with saline or silicone. The actual shell of the implant is the same. There are pros and cons of each. Saline implants are a little more affordable. They do however have more a little more wrinkling and rippling which is where the implant is visible through the skin. They also don’t feel quite as nature as silicone. Patients rate their implants in look and feel lower than patients with silicone implants. The saline that I use for the implants is directly from an IV bag. Rupture detection is quite easy with a saline implant because it just goes flat.

Silicone implants are by far the more popular implant. Silicone implants are nothing like the “old” silicone implants that were taken off the market in 1991. That silicone was a lot thinner, closer to the consistency of motor oil. Now, the standard silicone implants are significantly more viscous. They are approximately the thickness of a pudding. The nice part about that, should they rupture, the operation to exchange them, is nothing like the old one. In the old days the silicone would leak into the tissue and it was very challenging to get out. Comparatively, the exchange operating is very simple. From a safety point of view the silicone implants are completely safe. They have been exonerated from what they were accused of in the 90’s.

The newest generation of silicone implants have been coined “gummy bear implants”. The gummy bear or form stable implants are thicker and closer in consistency to a gummy bear. For certain ladies this does pose an advantage. It can maintain the height of the implant accentuating upper pole fullness slightly better. I regularly put in “gummy bear” implants but I try to discuss with the patient if this will actually be an advantage for them based on their dimensions and size goals. This is all done as part of an initial breast augmentation consultation.