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Breast Implant Complications

If any of the following apply, refer the patient to the symptomatic breast service: here

  • Palpable lump in breast
  • Breast ulceration, skin distortion or nodule, persisting nipple eczema, unilateral blood stained discharge or recent nipple retraction
  • Increased size of breast suggestive of fluid around the implant

 

If the patient had the original surgery privately, they should contact the provider to see what warranty systems are in place for removal and replacement. However, patients with suspected implant rupture or contracture can be referred to the Breast Clinic for assessment, irrespective of whether the original surgery was performed on the NHS or privately.

 

If there are proven issues with the implant, including:

  • Implant rupture
  • Grade IV capsular contracture
  • Implant is a PIP implant

then removal of the implant(s) can be performed on the NHS, butreplacement of breast implants is not commissioned.

 

This policy does not apply to women who have undergone breast reconstruction following surgery for cancer.

 

Breast Implant Associated Anaplastic Large Cell Lymphoma (Bi-ALCL)

Breast Implant Associated-Anaplastic Large Cell Lymphoma is a rare sub-type of T-cell non-Hodgkin lymphoma (NHL). It is thought to be associated with textured implants. Presentation is usually a collection of fluid (seroma) around the implant > 1 year following implant insertion.

Treatment is usually surgery alone but some patients may benefit from additional treatment (immunotherapy). The current estimated risk is approximately  1 in 24,000 implants.

There is currently no recommendation from MHRA to remove any asymptomatic implant

 

Date Reviewed                                 03/12/2019

Next Review Date                           03/12/2020

Author                                                  Dr I Boyd, RMS GP Sifter

Contributor                                        Dr Rebecca Osborne, GPwSI Breast, RCHT

 

 

Version No.  1.0