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Coming and Going

By: Miles Graivier, MD



Brazilian butt lifts rank as the most dangerous of all plastic surgery procedures, and buttock implants are known to have their fair share of complications and risks, but (pun intended) our patients still desire a shapelier derriere. A growing number of energy-based devices can now tighten and tone the gluteus maximus, gluteus medius, and gluteus minimus. There’s Cutera’s TruSculpt Flex, Allergan’s Cooltone, and BTL’s Emsculpt. The BTL and Allergan devices use high-intensity focused electromagnetic energy to stimulate muscle contractions, and the Cutera device relies on multi-directional stimulation technology.

Savvy marketing by these companies means word is getting out that we have safe and effective options to help patients achieve buns of steel. Brace yourself and your staff for a growing number of booty calls.



Allergan issued a worldwide recall of their Biocell textured breast implants and tissue expanders due to risk of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) after the FDA asked them to do so.

The recalled products include Natrelle Saline-Filled breast implants, Natrelle Silicone-Filled breast implants, Natrelle Inspira Silicone-Filled breast implants, and Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Filled breast implants. The recalled tissue expanders include the Natrelle 133 Plus Tissue Expander and Natrelle 133 Tissue Expander with Suture Tabs.

While textured breast implants are not that commonly used in the US, Allergan’s move indicates that rumors of the demise of these breast implants are not, in fact, greatly exaggerated. So far, there have been a total of 573 cases globally of ALCL related to breast implants and 33 deaths reported to the FDA. Of the 573 cases, 481 are reported to have Allergan textured breast implants at the time of diagnosis, the FDA reports. In addition, 12 of 13 deaths occurred in patients with a textured breast implant at the time of diagnosis. (The manufacturer and/or texture is unknown for the remaining 20 deaths.)

This headline-making news will likely (and understandably) cause concern among our breast augmentation and breast reconstruction patients. They should be told that in the absence of symptoms, the FDA is not recommending breast implant removal due to the low risk of developing BIA-ALCL. It can’t be overstated that this is a very rare cancer. Symptoms including persistent swelling or pain near the breast implant should prompt further evaluation. I suggest getting in front of the news and making sure all current and future breast implant patients are made aware of these symptoms and what to do should they occur.

Watch New York City plastic surgeon Bryan G. Forley, MD discuss the breast implant recall and what it means for patients and doctors: