Breast implants require long-term care

The Internet and women’s magazines are flooded with enticing ads on breast implants (breast augmentation) but experts and regulatory authorities have varying views on how long they last and their possible risks.

The implants, now at the center of a worldwide health scare, are manufactured by the French company Poly Implant Prothese (PIP) and appear to have an abnormally high rupture rate. That risk, though typically low, is present in all implants.

Breast implants have been on the market since the early 1960s, and were developed by two plastic surgeons in Texas, in cooperation with Dow Corning Corporation, a company specializing in silicone.

The first woman to ever have silicone breast implants was in 1962 in the USA. Since then, 5 to 10 million women worldwide, including an estimated 1.5 million to 2.5 million in the States, underwent breast implant surgery.

Although silicone implants are considered to deliver a more natural-looking appearance because they are more likely to look and feel like real breasts, safety concerns exist for years now.

Silicone or saline

In 1992, the U.S. drug regulatory authority, the Food and Drugs Administration (FDA), decided that silicone implants should be withdrawn from the domestic market because their safety had not been fully established.

However, the U.S. silicone implants were sold again in 2006 after the FDA approved implants sold by Allergan and Johnson & Johnson's (Mentor), on condition that the companies would follow a sample of 40,000 women for 10 years to examine all safety issues.

In Britain, breast augmentation is the most common cosmetic surgery performed on women, according to the Medicines and Healthcare products Regulatory Agency (MHRA). The procedure is also highly popular in Latin America.

In Brazil, about 200,000 to 300,000 breast implant surgeries are carried out annually, according to the Brazilian Plastic Surgery Society. Several implant types are available, including those made of natural tissue taken from other body areas.

This type of surgery is more usual in breast cancer patients undergoing breast reconstruction after a mastectomy. The most widely used implants in cosmetic surgery are silicone- or saline-filled devices which are placed under the breast tissue to boost size and enhance shape.

The implants are usually inserted via a small incision under the breast, but can also be put in through an incision in the armpit or around the nipple. The procedure is generally done under general anesthetic and lasts one-and-a-half hours.

No lifetime guarantee

Experts warn, however, that breast implants are likely to need long-term care. "Breast implants do not last a lifetime and they will need replacing at some point in the future," the British Implant Information

Society says on its website. It also says that modern implants are likely to last between 20 to 25 years, about 10 years longer on average than the older types developed in the early 1960s and 1970s.

In some countries, where implants are popular among very young women, e.g. in Venezuela it is not unusual for parents to give breast implant surgery to teenage daughters as presents, this could mean a woman will undergo breast surgery once and possibly twice in a lifetime.

According to experts, anyone offering significantly lower prices may offer a merely superficial surgery and follow-ups, and this is something patients should carefully consider.

Our personal experience since 1998 and up to now suggests that we did not have to change a worn out implant.


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