Dr. Robert Whitfield (plastic/reconstructive surgeon) discusses whether certain breast implant types are more likely to cause breast implant illness (which he frames as chronic inflammation). He notes textured implants—particularly aggressively textured Allergan surfaces—are most closely associated with anaplastic large cell lymphoma (ALCL) and can be more stimulating to surrounding tissues, though severe symptoms can occur with any implant type. He describes why texturing was used in reconstruction (to prevent rotation and stabilize shaped implants) and outlines his clinic's comprehensive evaluation strategy (functional genomics, toxicity testing, food sensitivities, gut microbiome and hormone evaluation) to identify root causes beyond the implant itself.
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New podcast Are certain types of implants more likely to cause breast implant illness? I get asked not only how breast implant illness develops, but I also get asked this question, are there more commonly associated types of breast implants that lead to breast implant illness? Let's just frame the discussion as I consider breast implant illness to be chronic inflammation. It affects and and I've seen it affect every single system of the body. Or does a specific or particular type of breast implant cause breast implant illness more frequent? So I see patients have or can have extreme symptoms with textured implants, but not in every situation. Textured implants are the most closely associated with anaplastic large cell lymphoma. They had a worldwide recall and in particular texturing surface of Allergan is really aggressive. It was brought to market and was certainly as a reconstructive surgeon, a tool that was used with the intention to keep the implant still, prevent it from rotating as it was shaped, and gave the cancer reconstruction patient the most comprehensive breast form that you could get with an implant. And it was important in that patient population, certainly prevent rotation. That's why their texturing was instituted to help with that, to keep it still, as was every manufacturer's texturing in that patient population. And certainly to prevent rotation with the shaped implant. That was really the purpose. So if everybody thinks about an oncology type reconstruction where all of the natural borders of the breast have been, if not removed, severely weakened, so that if you just placed an implant, it would simply move in and out of those spaces anymore because there's no natural borders. As a reconstructive surgeon, we would have to create a way for that to stay still in the pocket. And there were different techniques. Some would use total muscle coverage, some would use different biologic materials, all in the effort to hold it still. The tissue expanders were typically textured. That was the most common during my training period from 1996 until 05. And then in practice when I started in 05, that was very common. So those kind of rough for stimulating surfaces, although they hold the implant or the tissue expander in a more stable position, it certainly is stimulating to the tissues around it and can be one where you do see more symptoms. That being said, I've seen severe symptoms in every type of surface shape vendor, so just take it for what it's worth. That is certainly why at my clinic we take a comprehensive approach into evaluating the symptoms, identifying root causes using functional genomics, toxicity testing, food sensitivity testing, gut microbiome evaluation and hormone evaluation to make sure that we are identifying any root causes that we can to further help characterize why a patient is having symptoms. I'm a firm believer in evaluating everything, as the implant itself is only one factor in this. In my experience.
