University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Plastic Surgery


Dr. Larry Herman



Textured breast implants came to the market with an important goal: improving aesthetic results and decreasing capsular contracture. Over thirty years, the textured shell of gel-filled and saline implants proved superior to smooth-shell breast implants. Textured implants have some advantages, specifically with shaped implants requiring texturing for position stability. The rate of capsular contracture using textured breast implants is significantly lower compared to smooth breast implants. However, data shows that the textured surface of breast implants has its complications. One of them is the late-onset fluid collection, positive for CD30+, leading to the breast implants associated anaplastic large cell lymphoma. A late seroma doesn’t lead to Anaplastic Large Cell Lymphoma (ALCL); it is a sign of ALCL. Inflammation around the implant in the genetically susceptible patient can lead to ALCL. Although most patients who develop ALCL can be surgically cured if diagnosed early, metastasis has occurred and has led to death in at least 34 reported cases. The significant complication due to the textured part is death. The controversy among plastic surgeons is apparent and different opinions surround the question-"Should we continue using Textured Breast Implants?"

After conducting a two-day hearing on the use of textured breast implants, the Food and Drug Administration concluded that there was not enough evidence-based data to remove textured breast implants from the market. Experts in the plastic surgery field, immunology, and surgical device companies presented the data. They identified many causes that may lead to breast implants associated anaplastic large cell lymphoma and breast implants illness. However, given data locked certainty, that would make textured shell the causative agent for this disease development.

All panelists agreed that the industry needs to research and collect evidence-based data in the next decade to answer questions about textured shells and the safety of their use.


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