Long-Term Implications of Implant-Based Breast Reconstruction: What You Should Know About Breast Implant Illness and Breast Implant-Associated ALCL

Purpose of ReviewMany women who have a mastectomy will have implant-based breast reconstruction. Long-term complications from breast implant surgery include breast implant illness (BII) and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Here, we review recent literature regarding BII and BIA-ALCL.Recent FindingsBII is uncommon; however, some patients report systemic symptoms attributed to their implants. Patients with BII may benefit from implant removal without replacement. Current literature does not suggest that complete removal of the implant capsule adds any clinical benefit. Women with textured breast implants have increased risk of developing BIA-ALCL. Treatment consists of complete excision of the implant and capsule. Providers should follow updated NCCN guidelines for systemic therapies and surveillance.SummaryWomen considering breast implants should be properly counseled on potential long-term complications from implant reconstruction. Surgeons should be well informed of the signs and symptoms of breast implant-associated cancers and systemic illness.