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Plastic Surgery Center of Tulsa

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Information About BIA-ALCL and BII From Dr. Ratliff

[UPDATE: As of July 24, 2019, there have been 9 deaths in the United States attributed to BIA-ALCL]

You may have seen or read recent reports of a type of cancer associated with breast implants. This page is to provide you with the facts, as they are understood right now, of this extremely rare complication. As more is known, we will update this page but as always we welcome phone calls and/or office visits to discuss this relatively complex issue.


Breast implant associated anaplastic large cell lymphoma (BIA-ALCL) was first recognized around 2010-2011. The total number of reported cases is still less than 400 worldwide and that number is uncertain since there are dual reports of cases counted from different databases. The number probably will go up over time but may actually go down as the double counted cases are eliminated.

The American Society of Plastic Surgeons and the implant manufacturers Mentor, Allergan and Sientra have all been tracking this disease since it was first identified and have extensive information on all of the reported cases.

Summary of Knowledge May 2017

General Facts:

  1. BIA-ALCL is associated so far only with textured implants. The few reported cases involving smooth implants all had textured implants in place at some point, such as a textured saline replaced with a smooth gel.
  2. There is no difference in saline vs gel in number of cases.
  3. The FDA has specifically recommended that women not have surgery based on this issue, as the risks of surgery and anesthesia are much greater than the 1 in 500,000 to 1 in 750,000 risk of getting BIA-ALCL.
  4. Implant removal with capsulectomy has eliminated (cured) the disease in all but a few of the most advanced cases.

Plastic Surgery Center of Tulsa Facts:

  1. In 26 years, Dr. Ratliff has used less than 50 sets of textured implants in cosmetic augmentation. The vast majority of his patients (around 6500 at this point) have smooth implants. From 1991 to 2004, most of the reconstructive cases had textured implants, but not from the brand associated with the majority of the BIA-ALCL cases.
  2. Dr. Ratliff is on advisory boards for Mentor and Sientra and has been involved in discussions regarding BIA-ALCL and how to deal with it since it was first recognized.
  3. If a patient wants to come to discuss this in person, they are more than welcome to do so.

Additional updated information on BIA-ALCL from the FDA can be found at this links:

Questions and Answers about Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

The FDA Takes Action to Protect Patients from Risk of Certain Textured Breast Implants; Requests Allergan Voluntarily Recall Certain Breast Implants and Tissue Expanders from the Market: FDA Safety Communication