Dr. Greg Ratliff Addresses BIA-ALCL and BII Concerns

Hi, I’m Dr. Greg Ratliff and I’ve got some news, information, education, I’d like to share with you about two topics that have been in the news lately this being July of 2019. About two topics with breast implants -- one is called BII or breast implant illness and the other is BIA-ALCL, that stands for breast implant associated anaplastic large cell lymphoma. That’s why it goes by its initials, ALCL. Both of these things are topics that the FDA covered in 2 weeks of testimony and hearings and scientific presentations and at the end of that, the FDA affectively said while BIA-ALCL is a real disease and really associated with breast implants, at this point it is such a low number of cases, there is absolutely no reason to go and start taking breast implants out. The risk of doing that is far, far higher than your chance of getting this disease.

Now, to make it clear, this disease is associated only with textured surface breast implants. If you have smooth surface implants, there are no reported cases of BIA-ALCL. To drill down on that and be absolutely clear, there are some reported cases in reconstructed patients who had a textured implant and then got it replaced with a smooth implant. But there is always a textured implant involved. So, if you have been smooth all your life, no problem. The texturing is also associated one company a bit more than another company, and so you may have heard in Europe the FDA’s equivalent there, opted to pull that brand off the market. So they’re off. Most surgeons in the United States have simply stopped using textured implants until this is absolutely clarified, and I don’t have a problem with that. My entire career has been smooth implants. I never have really seen the value of texturing, so I didn’t ever use them except in a very few reconstructive cases way back in the 90s. So, if you are one of my patients and reading this, breathe easy, you don’t have a textured implant.

The cure for this, if it’s caught early, which is a swelling on one side, the cure for this is removal of the implant, removal of the capsule, and that so far has been 100% curative of this disease. This is not a “cancer, oh my God I’m going to die.” This is a disease that has to be dealt with. The four or five, five deaths that have occurred with this, thus far, were cases that were treated otherwise. They said, “Oh you’ve got lymphoma.” We send you to an oncologist; the oncologist went through six rounds of chemo therapy, implants still in place. Those people didn’t do well. If you have a breast implant and you have swelling on one side, your first call should be to a plastic surgeon. That’s the right thing to do. He’s going to know what this is. He’s going to know what to do about it. That’s the place to go.

I’m sorry to be so somber to be so somber on this, but it’s a potential disease with textured implants and that’s what I do, and you need to know the details about this.

Now, the other thing that’s been in the news is something called breast implant illness. Breast implant illness is a less defined constellation of symptoms, joint aches, dry eye, symptoms that are consistent with autoimmune type diseases. These diseases, in particular scleroderma were targeted with breast implants back in 1992 and led to a 14-year moratorium in the United States of no silicone implants, we used only saline. Lots and lots of research -- no connection was ever found. So, silicone came back on the market. Same constellation of symptoms. Still, there is absolutely no solid scientific proof that this is a real thing. The most telling study so far, and there again, in mind, this is July of 2019. So anything like this goes on for, you know, for years and years in terms of study. Scientific studies on this don’t happen in 48 hours, in spite what CSI Miami can do. We can’t do that. Breast implant illness so far, if you have these symptoms, and you have breast implants, and you have laboratory studies that show rheumatoid factor, increased inflammation, you have real evidence in the lab, and you get your implants removed. You do not get better. You have an autoimmune disease not caused by the breast implants. You have an autoimmune disease. You have scleroderma, you have Raynaud’s, you have something going on that has to get treated. On the other hand, if you have breast implants and you have these symptoms, and you have no lab findings, “they’ve tested me and they can’t find anything” and you get your implants out, those people have routinely gotten better. Is it their implants, or are they worried enough about their implants that they have symptoms? It doesn’t matter. The symptoms went away. So, if you are in that category and have negative lab results, get your implants out. Stop worrying about them and your symptoms will most likely clear. That’s the best advice available 2019 July. I may make another video in August 2019 saying “oh a paper came out this last month that says this.” But for right now, don’t panic over your breast implants. Learn the facts, and make decisions based on the facts. That’s all I can give you and that’s all you should do to yourself instead of getting worried. If you want to talk about this, you need to come in and visit about implants, 918-712-0888, Plastic Surgery Center of Tulsa.

Oh, one thing I left out the lymphoma. Breast implants associated with lymphoma…There are 2 registries for those patients internationally. Unfortunately, there are duplicates, where people have been registered in both, but even with both registries added together, this a little over 700 cases out of several million sets of breast implants. That’s why this is such a deal that the FDA says it’s a lot more risky to get your implants out than to worry about this disease. Still is a real entity and we’re watching, and we’re looking and we’re registering and we’re trying to find common denominators. The science is out there going after this problem to find out what to do with it, but you as an individual, as far as your risk for this, is very low. So take that, rest, don’t lose sleep over it, if you want to talk about it, come in and talk about it. Your plastic surgeon is a resource. Thanks.