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'My breast implants gave me cancer': Mother-of-3 describes how the disease left her skin cracking, bleeding, with lumps all over her body - but insurance REFUSED to pay to remove the implants
Jul 17, 2017 | Daily Mail
By Abigail Miller
A mother-of-three claims her breast implants gave her cancer, and said her insurer would not pay to have them removed. Kimra Rogers, 50, who lives in Caldwell, Idaho, was diagnosed with lymphoma in May 2016. -
'It's what the people want' - surgeon on increasing demand for natural alternative to breast implants
Jul 15, 2017 | New Zealand Herald
By Cherie Howie
An increasing number of women are opting for breast reconstruction or enlargement surgery that uses fat cells from their own bodies, instead of implants, a plastic surgeon who pioneered the surgery in New Zealand says.
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Jul 17, 2017 | Daily Mail
By Abigail Miller
A mother-of-three claims her breast implants gave her cancer, and said her insurer would not pay to have them removed.
Kimra Rogers, 50, who lives in Caldwell, Idaho, was diagnosed with lymphoma in May 2016.
To her horror, she was told the cancer was likely caused by her breast implants, which took her from a small B-cup to a large C-cup, that she had done 14 years earlier.
Although there are now schools of research explaining the links, Kimra claims she was never told about the risk when she went to have the procedure done.
The specific disease is called breast implant associated anaplastic large-cell lymphoma (BIA-ALCL), and according to the FDA it can develop from a certain type of breast implant.
'I remember telling my doctor: "They never once told me it would be a possibility I could get cancer if I got these implants",' Kimra told Daily Mail Online.
Dr Mark Clemens, a plastic surgeon at the Anderson Cancer Center in Houston, Texas, told Daily Mail Online that the cancer, while very rare, is much more common than people previously believed.
He has studied the disease since the FDA first released a warning about in 2011, and said it is most commonly found between eight and ten years after the augmentation surgery.
'Eighty percent of individuals experience a large fluid collection and expansion of the breast. Only a few feel a mass or swollen lymph node under their armpit,' he explained.
Dr Clemens also said it's important to note that BIA-ALCL is not a breast cancer, but instead a cancer in the scar tissue around the implant.
Implants are made with either a smooth or textured outer surface, and surgeons sometimes use the rougher option to limit its movement in the patient's body.
Lymphoma is a long sustained stimulation of the immune system, he explained, where the T-cell (part of the immune system) begins to replicate abnormally.
'It's almost like a prolonged allergic reaction that, if the patient is genetically susceptible, can turn into cancer,' Dr Clemens explained.
He also said that there are is no way to screen for the disease, but that it is something he thinks all women should be aware of. '
All surgery carries risk. But patients must be properly informed about what those risks are if they are to make a decision on whether to go ahead with it,' he said.
When a patient has been diagnosed with this cancer, it has a high cure rate, with the most important aspect being taking the implants out.
In Kimra's case, things weren't so simple, partially because she was initially diagnosed with the wrong kind of lymphoma, and in part because her insurers refused to cover the procedure because it was considered to be cosmetic.'I first went to doctors in 2015 when I started experiencing skin changes. Naturally I have very oily skin, I had to wash my hair every day it was so oily, but then as if overnight it got very dry,' she explained.
The mother-of-three said if she did not put moisturizer on multiple times a day, her skin would crack and bleed.
'Then about six months later my hair started falling out, and I was putting oil on my scalp. It was like I had dandruff but also large chunks of my hair would fall out in addition to the flaky skin,' she said.
Kimra went to a host of doctors and dermatologists who couldn't tell her what was happening.
Then she found the lump.
'On April 5, 2016, I was shaving my underarms and felt a large lump, the size of an egg. I went to the doctors and got blood work done and had an x-ray,' she said.
'My white blood cell count was low but not alarming. So then doctors did a mammogram and an ultrasound, and there you could clearly see the big mass and six or seven other smaller ones,' Kimra explained.
Her oncologist then removed all of the masses, and sent them off to labs at Stanford where it tested positively for cancer.
In May, Kimra was told she had stage 2 Hodgkin's lymphoma - which later transpired to be incorrect.
Her doctor said he believed the disease may have been triggered by her breast implants.
It was an unusual diagnosis. The most common cancer caused by breast implants is called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).
But Kimra said she was not tested for any other type of the disease, and trusted her doctor's verdict.
'When they said I had cancer, I thought, 'I'm a strong woman, I'm ready to fight,' it wasn't until I started receiving chemo that it really hit me hard, she said. 'I was more concerned about my husband.
'He'd lost his father from Hodgkin's lymphoma just a few months before I was diagnosed, and his sister had it as well, so when I was diagnosed he just started sobbing.'
Kimra went through with the treatment for Hodgkin's lymphoma, but later realized she had been misdiagnosed by her doctor.
'It was hard because my oncologist didn't treat it properly. He told me he thought breast implants caused it, but said they would start with chemo and radiation then talk about removing them,' she explained. 'I trusted him.'
She underwent six rounds of chemo and 25 rounds of radiation, spanning many months and finally ending in February. Following that treatment, she was told she was in remission.
It wasn't until Kimra connected with other women online who said their breast implants gave them lymphoma, but they all had the same type, BIA-ALCL, that she started to wonder if she was misdiagnosed.
Having trusted her doctor for months, Kimra was curious to investigate why her case was different.
In March this year, she requested her pathology report - and saw the CD-30 cancer marker tested positive, a marker which is directly linked to anaplastic large cell lymphoma.
Had she been diagnosed with BIA-ALCL from the start, she would have had her implants removed straight away.
'I thought, "what does he mean he thinks it was caused my implants. It says right here it was,"' she said. 'In the end, the cancer wrapped up into my neck and clavicle, so I would've had to have chemo anyway, but I at least would have had the source of the cancer out of my body.'
Now, even though she knows her implants triggered her cancer, she still has a while to wait until they can be removed.
'Surgeon's won't remove the implants until I'm six months past my last round of radiation,' she explained. 'Had I been correctly diagnosed and had them out in the first place, it's possible the whole ordeal would be over.'
Since being diagnosed Kimra has been in an uphill battle with her insurance agency.
Kimra's insurer, Blue Cross and Blue Shield of Montana, denied three times payment to remove them because it was a contract exclusion, related to 'cosmetic plastic surgery.'
After months of back and forth, BCBS finally agreed to pay for the implants to be removed, but have said they will not pay for the reconstruction.
'If I had breast cancer of course they would have let me have them removed and reconstructed, because it's another type of cancer it is considered to be cosmetic,' Kimra said. 'I'm definitely going to go a different route for reconstruction, though.'
Even if her insurance doesn't agree to cover reconstruction, Kimra said she is going to go forward with the surgery and will just pay for it out of pocket. She is now crowdfunding to raise money, expecting that this might be the case.
She also said she wants to spread awareness about this cancer, and the dangers of receiving the textured implants.
'While we do not generally cover cosmetic procedures, in the case of BIA-ALCL, we do cover medically necessary cancer treatments, including removal of implants, chemotherapy and radiation,' BCBS of Montana spokesperson John Doran told Daily Mail Online.
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Jul 15, 2017 | New Zealand Herald
By Cherie Howie
An increasing number of women are opting for breast reconstruction or enlargement surgery that uses fat cells from their own bodies, instead of implants, a plastic surgeon who pioneered the surgery in New Zealand says.
Whangarei-based plastic surgeon David Crabb began offering the surgery - known as large volume fat transfer - in New Zealand about five years ago and has operated on "hundreds" of women at his Whangarei and Warkworth surgeries since, he told the Weekend Herald.
He was aware of at least a couple of other New Zealand surgeons also offering the surgery.
Most patients were those who wanted their implants removed - following fears of potential ruptures or links to cancer - and replaced via the relatively new surgery, and women who had lost tissue after multiple pregnancies.
Others included those diagnosed with breast cancer, who made up about 30 per cent of private surgeries, Crabb said.
More people were turning to the surgery, which is more common overseas, as word of its benefits spread.
"It's what the people want ... it's definitely the treatment of choice for people intolerant to implants. [And] it's much safer ... I think implants are toast. I don't use implants and I wouldn't recommend them. I certainly wouldn't let anyone in my family have them."
Implants had caused concern with reports of painful ruptures.
There was also the "small risk" of developing a lymphatic cancer known as giant cell lymphoma, Crabb said.
"It's important not to panic people but it is fair to say it's causing concern."
Overseas media have reported concerns the lymphoma may be linked to textured breast implants, as opposed to smooth ones, with the Independent reporting this week that The Medicines and Healthcare Products Regulatory Authority was monitoring cases of the rare type of immune system cell cancer in women fitted with breast implants since 2011.
US media also reported this week that the Food and Drug Administration had published a report this year linking a rare cancer to the implants.
Meanwhile, Crabb, who has been a plastic surgeon for more than 30 years, said a major benefit for patients is the much faster recovery time.
The new breast went soft in about six weeks, allowing the recipient to lie on her front, and looked "completely natural". In contrast, implants often became permanently uncomfortable for recipients, he said.
The cost of the surgery in New Zealand depends on the individual circumstances of each patient, with some needing more than one operation.
Some health insurers paid, but he had done some publicly-funded operations. He was unsure which district health boards offered the surgery to patients.
Potential patients should speak with their plastic surgeon, Crabb said.
One of Crabb's patients, Deborah Connors, is among New Zealand women who have had their implants removed and replaced with fat cells.
The 59-year-old received implants in the United Kingdom in 2004, but later found out the implants were manufactured by a French company which used unapproved silicone filler.
Suffering joint pain and rheumatic problems some medical professionals thought may be related to the implants, the Whangaparaoa woman began saving to have the implants removed.
"Once you've got the wrong thing in you, it's just in the back of your mind. You just want them out."
Her single surgery took place two years ago and cost $25,000. While there was pain afterwards, she was fine after a couple of weeks and her pre-existing pain had disappeared.
"It's just so nice and you have ... peace of mind. You know that all your body is your own."
Upper Hutt woman Rachel Jacobson has also undergone Crabb's pioneering surgery.
The mum-of-four had a single mastectomy, with an implant later, after being diagnosed with breast cancer in 2015. But the implant never looked right, caused her ongoing pain and left her feeling like she had the flu all the time.
She began researching an alternative, found Crabb and eventually underwent three surgeries to complete the implant removal and reconstruction.
"It's painful, but it's a quick recovery."
Her surgeries were covered by her health insurer, except for about $6000 in excesses, and had changed her life, Jacobson said.
As well as being pain free, her new breast looked and felt normal.
"When you've had breast cancer [before reconstruction] you get out of the shower or look in the mirror and there's that constant reminder. [Now] I don't think about it because it just looks like my other breast.
"You don't want to forget about it, you want to be able to help other people, but you don't want to be focused on it all the time."
A Ministry of Heath spokesman said breast reconstruction surgery was performed in the public sector and mostly by plastic surgeons.
Access to care was determined based on a patient's clinical priority, which focused on their level of clinical need and ability to benefit from the procedure. There was a separate process for those seeking elective surgery.
"In terms of the technique used, clinicians are responsible for determining the most appropriate technique for each patient, depending on their condition and suitability."
The ministry did not have a breakdown of the specific techniques used, the spokesman said.
Clinical practice and techniques were overseen by the Royal Australasian College of Surgeons and the New Zealand Association of Plastic Surgeons, he said.
Information on the number of women affected by implant-related issues was not available.
HOW DOES LARGE VOLUME FAT TRANSFER SURGERY WORK?
The first half of the operation involves harvesting fat cells from other parts of the body, such as the thighs or abdomen.
The cells are then harvested at a reduced temperature, washed with special fluids, separated using gravity before being centrifuged and separated into 3mm syringes.
Passes, where 0.16mm of the cells are syringed into the patient, are then made, with hundreds of passes taking place over the course of the surgery.
There are no major cuts made, only small incisions.
Because the surgeon is able to control the direction of the instrument used, they are able to create a 3D mesh. This is then able to expand, resulting in the construction a new breast.
Once there is no room left for more cells to be added the operation is complete, although in some cases another operation may take place if it is later found that more volume is needed.
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