A new national registry has been established by the American Society of Plastic Surgeons and the FDA to document reported cases of a rare condition  , Anaplastic Large Cell Lyphoma (ALCL) which is possibly associated with breast implants.  Thirty four cases of ALCL  in patients with breast implants have been reported in the world and that is in the 5-10 million women who have implants world wide.  Most of the patients presented with late onset seromas ( swelling) around their breast implants .  The condition appears to arise in the capsule surrounding the implants and is not breast cancer.  Currently the recommendation for women who are found to have this condition is to remove the capsule ( scar tissue) which surrounds the implant as well as the implant.  Safety is always of first concern and I  concur with the the American Society of Plastic Surgeons , the Aesthetic Society as well as both implant companies (Mentor and Allergan) in supporting efforts to research this rare condition .

Recently I went to Sweden to observe the practice of Dr Charles Randquist.  Dr Randquist has extensive experience with form stable breast  implants -  Mentor’s CPG implants and Allergans 410 implants -  which are not currently available in the USA except under study conditions.  These implants are shaped -  with a sloping upper pole .  We used to have shaped implants in the United States but the FDA did not include them in the approval process along with round implants so they were taken off the market in the States five years ago.    I am hopeful that soon we will have shaped implants as I think especially for the reconstruction patient they are a valuable tool.

A few years ago I surveyed a group of female plastic surgeons as to what they would choose for reconstruction if they were faced with the diagnosis of breast cancer.,  My thinking was that this group of doctors had an unique perspective on breast reconstruction options -  they were very well informed as to  not only the options available but also to the risks and outcomes of each reconstructive option .  The results were interesting.,  A total of 54 female plastic surgeons were surveyed.  Ninety one percent stated that they would opt for mastectomy over breast conservation .  Most   (87%) choosing a mastectomy would opt for reconstruction.  For their reconstructive procedure 54% would choose tissue expansion with implant reconstruction and, 28% would choose a Tram flap and only 5% would choose a latissimus flap.  For the women choosing implant reconstruction 79% would choose a silicone implant , 24% would choose a saline implant and one respondent felt that either choice would be acceptable.  The most frequently chosen reconstruction then was tissue expansion followed by a silicone implant (43%).  Interesting  and food for thought!

I was just asked about the expected lifetime of breast implants. All patients with Mentor MemoryGel breast implants are automatically eligible for the Mentor Lifetime Product Replacement Policy.    Just to show how much implant companies stand by their products -Mentor Corporation is offering a limited time Premier Advantage breast implant warranty  which includes: in addition to lifetime product replacement - 10 years of financial assistance from the date of implant of up to $3,500 in surgical assistance, free contralateral implant rep[lacement and non -cancelable terms.This definitely is a long term commitment from Mentor!     I have told many patients that the products must be made well or the company could not offer this sort of warranty.  This additional warranty is free but this offer is only available for surgeries done between May 1st, 2009 and December 31, 2009.  After that time the optional  warranty coverage will again be $2400 and cost $100.