Breast implants have a long track record, but no medical device is risk-free, and you deserve clear, honest information about the rare cancers associated with them. Here is what I tell my patients — what is known, and what is still uncertain.

What BIA-ALCL is

BIA-ALCL stands for breast implant-associated anaplastic large cell lymphoma. It is not breast cancer. It is a rare lymphoma — a cancer of the immune system — that can develop in the fluid and capsule around an implant. The World Health Organization formally recognized it as a distinct entity in 2016. The most common sign is a new, delayed swelling of the breast that appears years after surgery. A systematic review and meta-analysis in Aesthetic Plastic Surgery that pooled 17 studies (525,475 patients with implants) reported a mean time to diagnosis of about 13 years.1

How rare is it, and who is at risk?

BIA-ALCL is rare, and the risk is strongly tied to textured-surface implants rather than smooth implants. From the published evidence:

  • The Aesthetic Plastic Surgery meta-analysis found the association was almost entirely with textured implants and estimated risk in the range of roughly 0 to 1 case per 1,000 patients with implants.1
  • U.S. epidemiology work has characterized incidence and cases in the American population.2
  • Data from Australia and New Zealand pointed to the highest risk with higher-surface-area (“grade 4”) textured implants.3
  • A separate analysis estimated current risk specifically in textured implants.4
  • In 2024, the American Association of Plastic Surgeons published a consensus statement summarizing current understanding.5

Because of that textured-implant association, I most commonly use smooth-surface implants for cosmetic augmentation. You can see the brands I work with on my implant options section.

Is it treatable?

Yes. When found early, BIA-ALCL is often treated effectively — typically by removing the implant and the surrounding capsule. Prognosis is generally favorable with timely, appropriate treatment guided by an oncology team. That is exactly why I want any new or delayed breast swelling evaluated rather than watched.

What about squamous cell carcinoma (BIA-SCC)?

In September 2022 the FDA reported that cancers — including squamous cell carcinoma (SCC) and various lymphomas — have been found in the capsule that forms around breast implants, and it issued an updated safety communication in March 2023.6 A few points I think are important for patients:

  • Capsule-associated SCC is distinct from BIA-ALCL — it is a different type of cancer, not the same lymphoma.
  • The FDA has described these as likely rare, noting it was aware of a small number of SCC cases from the published literature at the time of its communication.6
  • Reported warning signs have included swelling, pain, a lump, or skin changes — again, the practical message is that any new or persistent change around an implant deserves prompt evaluation.

The science here is still developing, and I follow the FDA’s guidance closely. The FDA maintains a plain-language overview of implant risks and complications as well.7

What this means for you

  • BIA-ALCL is rare, primarily associated with textured implants, and usually treatable when caught early.
  • Capsule-associated SCC is a separate, rare finding the FDA is tracking.
  • Know your implant type and keep your implant card and records.
  • See me for any new swelling, lump, pain, or breast change — even many years later.

References

These sources are provided so you can read the primary literature yourself. Links open on PubMed, PMC, or FDA.gov.

  1. Dahy AA. The Risk of Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Systematic Review and Meta-Analysis. Aesthetic Plast Surg. PMC
  2. U.S. Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma. PubMed
  3. The Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand Confirms the Highest Risk for Grade 4 Surface Breast Implants. PubMed
  4. Current Risk Estimate of Breast Implant-Associated Anaplastic Large Cell Lymphoma in Textured Breast Implants. PubMed
  5. American Association of Plastic Surgeons Consensus on Breast Implant-Associated Anaplastic Large-Cell Lymphoma. PubMed
  6. U.S. Food & Drug Administration. UPDATE: Reports of Squamous Cell Carcinoma (SCC) in the Capsule Around Breast Implants — FDA Safety Communication. FDA.gov
  7. U.S. Food & Drug Administration. Risks and Complications of Breast Implants. FDA.gov
Breast Implant Safety Series

Part of Dr. Levesque’s in-depth series on breast implant safety.

Breast Implant Illness: What We Know & How It’s Treated →Capsular Contracture: Grading, Avoidance & Treatment →Breast Augmentation: Published Implant Safety Data →
breast implantsBIA-ALCLBIA-SCCimplant safetybreast revision