BREAST IMPLANTS REMOVAL IN MONTREAL
Dr. Danino's clinic welcomes you and accepts patients for breast implant removal in Montreal. Breast implants have been at the heart of Dr. Danino's research for 20 years. He was the first in 2000 to describe the characteristics of the Biocell macrotextured implant, in particular in the following article :
​
​
Later, in the slow understanding of the phenomenon of late seroma and double capsule, the impact of Dr. Danino and his team was crucial (see article The double capsules in macro-textured breast implants), in particular in the description of the necessary stability of the implant after its placement (see articles A Step Forward Toward the Understanding of the Long-Term Pathogenesis of Double Capsule Formation in Macrotextured Implants: A Prospective Histological Analysis, and The Impact of Postoperative Expansion Initiation Timing on Breast Expander Capsular Characteristics: A Prospective Combined Clinical and Scanning Electron Microscopy Study) and in the need to prevent any infection (see article Do Bacteria and Biofilm Play a Role in Double-Capsule Formation around Macrotextured Implants?). He gained a worldwide recognition for the corpus of 132 papers he published on the subject.
BREAST IMPLANT-ASSOCIATED ANAPLASTIC LARGE CELL LYMPHOMA (BIA-ALCL)
​
In 2011, the FDA raised concerns over a possible connection between breast implants and anaplastic large cell lymphoma (ALCL), which is not breast cancer but a type of T-cell lymphoma (cancer of the immune system). Because of gaps in implant sales data, it is difficult to determine the rate of breast implant-associated ALCL, but the FDA estimates that 1 in 3,817 to 30,000 recipients could be affected. This cancer has been found regardless of implant filling and texture, but people whose implants have a macrotextured surface rather than a smooth surface are also more likely to experience these complications. Most of the breast implants and anaplastic large cell lymphoma (ALCL) were found with Biocell textured implant from Allergan and polyurethane implants.
On April 4, 2019, in a press release, Health Canada decided to withdraw the Biocell implants for public protection. In this announcement, the warning signs are explained (pain, sudden swelling or mass). But routine removal of breast implants is not recommended in the absence of signs or symptoms suggestive of BIA-ALCL.
BREAST IMPLANT ILLNESS (BII)
Breast implant recipients continue to report symptoms similar to those of autoimmune disorders, including fatigue, muscle and joint aches, fevers, dry eyes and mouth, and occasionally poor memory or concentration. Although it is not technically a medical diagnosis, these symptoms are referred to as breast implant illness (BII).
Breast implant illness remains a challenging issue. However, the lack of robust epidemiologic evidence to support the association should not stop the pursuit of ongoing scientific evaluation. The timeline from the emergence of a disease entity to characterization and identification of underlying pathogenesis can take decades and will require significant funding for both epidemiologic and laboratory investigations. The variability and broad range of symptoms, the lack of clear diagnostic criteria, the absence of long-term safety and efficacy data, and the need for better understanding of the interaction between host and implant cloud the picture. It is our responsibility to approach these patients as caregivers because a substantial number will be improved by surgical implant removal and capsulectomy.
An article in Plastic and Reconstructive Surgery Journal by Rohrich et al. (2000) also assessed patients presenting for explanation and showed that there was a statistically significant improvement in subjective health for patients who are distressed by their implants.
A 2013 study published in the Netherlands Journal of Medicine found that most or all of the symptoms went away in 69 percent of women who had their implants removed.
REMOVAL OF BREAST IMPLANTS AND EN BLOC CAPSULECTOMY
​
Total block capsulectomy is the procedure of choice for patients with these conditions. This is a procedure that aims to remove together the implant and the scar tissue (fibrous capsule) that has formed naturally around the breast implants. This is a delicate operation under general anesthesia, under the mammary route, with an operating time of approximately 3 to 4 hours.
