woman with elbows in front of breasts

woman with arms in front of breastsBreast augmentation is the most popular cosmetic surgical procedure in the U.S. Breast implants have been used since the 1960s and are one of the most heavily scrutinized and investigated medical devices in history. The types of implants available today, combined with continual refinement of breast augmentation surgery, make the procedure more reliable than ever before. All surgery, however, carries some risk and both regulatory agencies and practitioners continue to ensure the safety of the patient remains paramount.

There has recently been renewed discussion surrounding the safety of silicone implants, in large part stemming from the global recall of Allergan’s textured Biocell breast implants in July this year. The recall of the Allergan Biocell implant was due to findings that this particular implant – used in less than 5% of all breast implant surgeries in the U.S. – is associated with the risk of anaplastic large cell lymphoma (BIA-ALCL), a rare but highly treatable form of immune system cell cancer.

The current risk of contracting BIA-ALCL is very rare – estimated to be 1 in 3,817 to 1 in 30,000.  All of the cases have been linked to textured breast implants, not the smooth implants more commonly used in the U.S.

Dr. William Koenig, double-board certified plastic surgeon with one of the lowest surgical complication rates (less than 1%) in the country, stresses that BIA-ALCL is rare and patients should be aware that breast implants in general are still very safe, as is breast augmentation surgery.

“To date, there have not been any confirmed BIA-ALCL cases that involve only a smooth implant, which is the type I routinely use,” he says. “The risk of contracting BIA-ALCL is very low, so unless there are symptoms such as a sudden swelling of the breast years after surgery, women do not need to have their implants removed. However, we recommend all women get their implants checked regularly by their surgeon.”

Dr. Koenig is a trusted authority on breast implant surgery, and no one in Upstate New York has more experience. Breast augmentation is his most requested surgery, and he remains an expert in best practices for the procedure. He has performed more than 5,000 breast implant surgeries and has more than 26 years of experience in breast augmentation.

BIA-ALCL vs. “breast implant illness”

There have been anecdotal accounts of breast implants causing a variety of general health issues, collectively known as “breast implant illness.” Symptoms are non-specific and include general fatigue, joint aches, headaches and brain fog. To date, there is no evidence that breast implants are causing these problems and there is no known link between these symptoms and BIA-ALCL.

Key takeaways

  • The FDA does not recommend removal of any type of breast implant in patients who have no symptoms (persistent swelling or pain in the area of the breast implant usually years after surgery) due to the low risk of BIA-ALCL.
  • BIA-ALCL has not been associated with the use of smooth implants (which Dr. Koenig routinely uses).
  • “Breast implant illness” is separate to BIA-ALCL and evidence is lacking whether it is connected to a variety of general health issues such as muscle aches and fatigue.
  • Breast implants shouldn’t be viewed as lifetime devices; however, they do not need to be replaced if there isn’t a problem with them, even after the so-called “10-year rule.”

If you are considering breast implants, ask your surgeon about the benefits and risks of the different types of implants and always ensure your surgeon is a board-certified specialist plastic surgeon to help minimize the risk of complications and maximize results.

For more information on breast implants and breast augmentation, please call our office at (585) 244-1000 or request a consultation.


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