A priority at Montecito Plastic Surgery is to ensure our patients are informed about their procedure. We do this so that you feel confident and comfortable with your decision. In line with this philosophy, we have pulled together this page on a topic we noticed was riddled with misinformation. If you want to see the FACTS on the risk of cancer with breast implants, keep scrolling.

breast augmentation surgery patient

Some Quick Facts

Implants and Cancer: Quick Facts
Breast cancer survival rates are the same for patients with and without breast implants.¹

BREAST IMPLANT ASSOCIATED ANAPLASTIC LARGE CELL LYMPHOMA (BIA-ALCL) is extremely rare and is associated with abnormal capsules and fluid collections almost exclusively following placement of textured breast implants.²

Dr. Lowenstein uses smooth implants exclusively which minimizes any risk of BIA-ALCL.

BIA-ALCL is EXTRAORDINARILY rarely, if ever, associated with smooth-shelled implants — the ones most often used at Montecito Plastic Surgery.²

If you do get textured implants, the risk of getting BIA-ALCL is 1 in 30,303 (33 per 1,000,000 patients).²

Why Patients Worry

Breast implants are one of the most frequently performed plastic surgery procedures in the world. Still, many patients fear this procedure comes with significant risks.

Questions we hear often are concerned with if breast implants are related to breast cancer and whether patients with breast implants are at a higher risk for cancer. Patients also wonder if breast implants make it difficult to detect cancer.

In recent years, sensational reports on Breast Implant-Associated Anaplastic Large Cell Lymphoma (ALCL) have made women think twice about breast augmentation. They have also caused worry in those who already have implants.

We believe that patients should be informed about the risks and benefits of having breast implants. Here, we shall focus mainly on the small but possible risk of cancer.

Breast Cancer Risks: What We Know

Research over the years shows no evidence that women with implants are at a greater risk for cancers of the breast, including lobular or ductal breast cancers.³

breast augmentation patient

But you might still worry that implants can make it harder to detect breast cancer. There are two lines of thought when it comes to this:

Some breast cancer experts believe that the stretching of breast tissue that happens with implants makes it easier to feel smaller breast cancer nodules. This theory suggests it is easier to detect breast cancer early in women who have had breast implants.

Other experts believe that implants can make it harder to detect cancer when it forms near implant edges or, rarely, behind the breast implant.

But what both camps can agree on is that the survival rates for women with implants and those without are the same, and this has been shown in scientific studies.¹

What this means is that — while many patients with implants may be able to detect cancer sooner, and others may experience a delay in diagnosis — survival rates do not differ between the two groups.

This also means that patients with breast implants should continue their usual screening for breast cancer as instructed by their primary care doctor or OBGYN.

plastic surgery patient

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What About BIA-ALCL?


First things first: Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is NOT breast cancer.

It is a rare cancer of the T-cells, which are part of the immune system. It is a type of non-Hodgkin’s lymphoma.

This cancer can occur in different parts of the body but also in a small number of patients who have had breast implants — specifically implants that have a textured surface (the kind Dr. Lowenstein does not use).

In breast implant patients, ALCL often occurs many years after breast augmentation and is usually associated with a rare complication called a seroma. A seroma is a fluid collection that forms around the breast implant. In a small portion of patients with this fluid collection, BIA-ALCL has been found in the overlying scar tissue (the capsule) rather than in the breast tissue itself. Seromas themselves are quite rare, and many seromas are not associated with BIA-ALCL, but the occurrence of a seroma is an indication to look for this complication.

An important thing to keep in mind is that BIA-ALCL is rare and that the vast majority of cases are associated with a specific type of breast implant — one with a textured surface.²

Knowing actual numbers may also put your mind at ease.

The number of reported cases of BIA-ALCL is very low: as of August 2020, there were 733 confirmed cases of BIA-ALCL and 36 confirmed deaths worldwide.

Compared to the number of yearly breast augmentations, this number is low. The American Society of Plastic Surgeons estimates that in 2020 alone, there were 193,073 breast augmentations in the U.S. (a 33% drop due to the COVID-19 pandemic). Also, breast augmentations have been performed in the U.S. since the 1960s, and there are an estimated 10 million women in the world currently living with breast implants.

Furthermore, a large epidemiological study found that only 3.3 out of every 1,000,000 women in the U.S. with textured breast implants will develop BIA-ALCL.² In other words, 1 in every 30,303 women with these implants will develop the disease over their lifetime. Even so, the death rate for them remains low as there have been only nine confirmed deaths due to BIA-ALCL.

In other words, you are more likely to die due to other diseases and accidents than BIA-ALCL. Just consider estimates from the Insurance Information Institute (III):

  • Dying from heart disease… 1 in 599
  • Dying from any accident… 1 in 2469
  • Dying from pneumonia… 1 in 6622

And for those born in 2013:

  • Dying from a motor vehicle accident… 1 in 113
  • Being killed by a firearm… 1 in 358
  • Drowning while in or falling into swimming pool… 1 in 6,162


Are breast implants safe?

Everything in life comes with some risk, which is also true for breast implants. But we can say that they are relatively safe.

Some brands of textured breast implants are now recalling their products due to FDA warnings to protect women’s health, notably Allergan’s BIOCELL line of textured breast implants. Dr. Lowenstein has never used Biocell implants and currently does not use textured implants at all unless specifically requested by the patient.

Dr. Lowenstein will continue to minimize risk to his patients by using smooth breast implants, which are VERY rarely associated with BIA-ALCL. He will also continue to recommend follow-up, as noted by the FDA. Should a patient at risk for BIA-ALCL consult Dr. Lowenstein for a workup, we will be happy to evaluate your situation. Patients considering breast implants should know that their risk for ALCL at our clinic is extraordinarily low.

If you are concerned that you may have a seroma, or if you have silicone breast implants over 5 years old and have not had your recommended MRI, contact our office. Dr. Lowenstein has negotiated a discounted rate for MRI studies at Pueblo Radiology for his patients. Contact us here.

How is BIA-ALCL treated?

Most cases of BIA-ALCL are treated by removing the implant and the capsule around it. Sometimes, chemotherapy and radiation may also be required. This usually takes care of the issue without further complication or death.

Is BIA-ALCL fatal?

The death rate for BIA-ALCL is low. The condition is treatable and there have been only nine deaths from BIA-ALCL in the U.S. so far. The majority of BIA-ALCL cases are discovered early due to noticeable fluid collection (seroma).²

What is a seroma?

A seroma is a fluid collection that can happen following many different surgeries. BIA-ALCL usually manifests as a late-appearing seroma with associated ALCL found in the capsule and, sometimes, the fluid around the seroma.

Seromas are very rare following breast augmentation, and only a minor percentage of seromas from breast implants harbor ALCL. If you suspect you have a seroma because one or both of your breasts have changed in size or appearance, contact your plastic surgeon for further workup.

What should I do if I have breast implants?

Follow-up is an important aspect of having breast implants. Dr. Lowenstein tells his patients to call or schedule an appointment if they have any concerns about their breast implants. The FDA also recommends that patients with silicone gel implants have regular MRI screening, not for BIA-ALCL but for rupture. Followup is important for all types of procedures- in plastic surgery, orthopedic surgery, abdominal surgery, or following most any procedure.

Does it matter if my implants are saline or silicone?

Breast cancer rates are no different for saline or silicone breast implants since true breast cancer does not seem to be related to having breast implants. BIA-ALCL can occur in textured surface implants that are either silicone gel or saline-filled.

I am worried that I have a seroma. What should I do?

If you believe you may have a thick capsule or a seroma, you should see your plastic surgeon for an evaluation. Remember that most seromas and thick capsules are not associated with cancer of any kind. Still, it is wise to speak to a Board-Certified plastic surgeon.

Has Dr. Lowenstein ever seen a patient with BIA-ALCL?

No. BIA-ALCL is rare, and despite Dr. Lowenstein’s extensive experience with his own breast implant patients and breast implant revisions for augmentations done by other surgeons, he has never seen a case of BIA-ALCL.

Why has there been so much news about BIA-ALCL in recent years?

The FDA has been taking steps regarding textured breast implants. Unfortunately, the news services have lead with headlines such as “Breast Implants Can Cause a Rare Form of Cancer” (NBC) instead of “Breast Implants Can Rarely Cause an Often Curable Form of Cancer”


Deapen D. Breast implants and breast cancer: a review of incidence, detection, mortality, and survival. Plast Reconstr Surg. 2007;120(7 Suppl 1):70S-80S. doi:10.1097/01.prs.0000286577.70026.5d

Doren EL, Miranda RN, Selber JC, et al. U.S. Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Plast Reconstr Surg. 2017;139(5):1042-1050. doi:10.1097/PRS.0000000000003282

Noels EC, Lapid O, Lindeman JH, Bastiaannet E. Breast implants and the risk of breast cancer: a meta-analysis of cohort studies. Aesthet Surg J. 2015;35(1):55-62. doi:10.1093/asj/sju006

Questions about Breast Implants & Cancer Risks? Contact Us today or call (805) 969-9004

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