Silicone breast implants are safe, but only diamonds are forever
Jul 26, 2011 Posted by Martha Drezin
Nothing that goes into your body can escape the whims of nature.
Today’s fashions are not for the fainthearted or the flat chested. Necklines feature, flaunt, highlight and showcase the female breast. Deeply cut, flowing tunics are meant to drape over a rounded bosom. Without breasts, fabric may hang in a lank puddle of despair. If you don’t have melons, let alone grapefruits or oranges, you may feel inadequate; alternately, you may decide to flaunt your flatness with flair, like a fashion model.
If you’re considering breast enhancement, bone up on the new FDA information about silicone breast implants. For women in their 20s and 30s, when most women get breast implants, and for other women as well, this is what you need to know: breast implants are not lifetime devices. Like your car or vacuum cleaner, your silicone breast implants will not last forever; they may need removal or replacement within a decade. It’s not like they’re designed for extinction, it’s just that they’re placed in a living organism, you, and subject to the whims of nature.
Of those who choose silicone implants for cosmetic purposes, 20 to 40 percent will have problems leading to removal or remodeling. Of those who get implants following mastectomy, chances of needing implant removal are even greater; 40 to 70 percent of breast cancer patients need implant removal or revision. For both groups, this is the maintenance plan: the FDA recommends that you get an MRI every two years to screen for “silent ruptures” in your implants. Unlike saline implants, which deflate when they tear, silicone implants do not deflate, so imaging is necessary to ensure that your implants are intact.
Capsular contracture, which is shrinkage of the space containing the implant, is the most frequent problem leading to reoperation. Other implant problems are rupture, wrinkling, asymmetry, scarring, pain and infection. This is not an appetizing list, but at least these problems are “local,” not systemic, and can be dealt with surgically.
The best news from the FDA is, “Studies to date do not indicate that silicone gel-filled breast implants cause breast cancer, reproductive problems, or connective tissue disease, such as rheumatoid arthritis.” But the FDA also states that no study has been large enough or long enough to completely rule out these and other rare complications.
The biggest worry about silicone implants has been their association with a rare type of breast lymphoma. But now, Dr. Jeffrey Shuren, director of the FDA’s Center for Devices and Radiological Heath, calls this possibility “profoundly small.”
New data was produced because the FDA, after putting silicone back on the market in 2006 (following a hiatus of 14 years), required implant makers, Mentor and Allergan, to do long term studies. From 1992 to 2006, silicone implants were banned because of worries about safety. This ban was upsetting for many women because silicone looks and feels more real than saline implants. Saline implants, essentially a sack of salt water, can form ripples, which are lovely in a lake but never a good fashion statement.
Critics of the recent FDA report say there’s not enough data to back up the Agency’s safety claims because many women dropped out of the study. The FDA is currently working with the implant companies to improve patient participation.
A recent news article from the American Society for Aesthetic Plastic Surgery notes that “the average size of women’s breasts is getting larger...and the phenomenon of increasing breast size is being seen worldwide.”
If this phenomenon has passed you by and your clothes are hanging in all the wrong places, you can consider silicone breast implants, but know the rules: (1) understand that your silicone implants may need replacing, (2) choose a board-certified plastic surgeon who is geographically accessible and therefore available for follow-up visits, and (3) Undergo MRI every two years to make sure your silicone implants are intact.
Martha Drezin
Today’s fashions are not for the fainthearted or the flat chested. Necklines feature, flaunt, highlight and showcase the female breast. Deeply cut, flowing tunics are meant to drape over a rounded bosom. Without breasts, fabric may hang in a lank puddle of despair. If you don’t have melons, let alone grapefruits or oranges, you may feel inadequate; alternately, you may decide to flaunt your flatness with flair, like a fashion model.
If you’re considering breast enhancement, bone up on the new FDA information about silicone breast implants. For women in their 20s and 30s, when most women get breast implants, and for other women as well, this is what you need to know: breast implants are not lifetime devices. Like your car or vacuum cleaner, your silicone breast implants will not last forever; they may need removal or replacement within a decade. It’s not like they’re designed for extinction, it’s just that they’re placed in a living organism, you, and subject to the whims of nature.
Of those who choose silicone implants for cosmetic purposes, 20 to 40 percent will have problems leading to removal or remodeling. Of those who get implants following mastectomy, chances of needing implant removal are even greater; 40 to 70 percent of breast cancer patients need implant removal or revision. For both groups, this is the maintenance plan: the FDA recommends that you get an MRI every two years to screen for “silent ruptures” in your implants. Unlike saline implants, which deflate when they tear, silicone implants do not deflate, so imaging is necessary to ensure that your implants are intact.
Capsular contracture, which is shrinkage of the space containing the implant, is the most frequent problem leading to reoperation. Other implant problems are rupture, wrinkling, asymmetry, scarring, pain and infection. This is not an appetizing list, but at least these problems are “local,” not systemic, and can be dealt with surgically.
The best news from the FDA is, “Studies to date do not indicate that silicone gel-filled breast implants cause breast cancer, reproductive problems, or connective tissue disease, such as rheumatoid arthritis.” But the FDA also states that no study has been large enough or long enough to completely rule out these and other rare complications.
The biggest worry about silicone implants has been their association with a rare type of breast lymphoma. But now, Dr. Jeffrey Shuren, director of the FDA’s Center for Devices and Radiological Heath, calls this possibility “profoundly small.”
New data was produced because the FDA, after putting silicone back on the market in 2006 (following a hiatus of 14 years), required implant makers, Mentor and Allergan, to do long term studies. From 1992 to 2006, silicone implants were banned because of worries about safety. This ban was upsetting for many women because silicone looks and feels more real than saline implants. Saline implants, essentially a sack of salt water, can form ripples, which are lovely in a lake but never a good fashion statement.
Critics of the recent FDA report say there’s not enough data to back up the Agency’s safety claims because many women dropped out of the study. The FDA is currently working with the implant companies to improve patient participation.
A recent news article from the American Society for Aesthetic Plastic Surgery notes that “the average size of women’s breasts is getting larger...and the phenomenon of increasing breast size is being seen worldwide.”
If this phenomenon has passed you by and your clothes are hanging in all the wrong places, you can consider silicone breast implants, but know the rules: (1) understand that your silicone implants may need replacing, (2) choose a board-certified plastic surgeon who is geographically accessible and therefore available for follow-up visits, and (3) Undergo MRI every two years to make sure your silicone implants are intact.
Martha Drezin