Breast Implants: Safe, Risky, or Just Risque?

Mr. Jean-Claude Mas, founder of the breast implant manufacturer Poly Implant Prostheses (PIP), self-admittedly hid the truth about his inferior quality breast implants for 13 years solely because doing so was financially beneficial to his company. Moreover, he claims that he was helped to do so by the fact that regulatory agencies warn a company about when they are coming. Interestingly, this warning the labs of an upcoming inspection appears to also be an Occupational Safety and Health Administration (OSHA) practice, so the problem is not restricted to Europe. Many is the time we cleaned up our laboratory in preparation for an inspection.

But, back to implants. About 3% of American women have them. In 2010 alone there were over 93,000 post-surgery reconstructions and 296,000 augmentation surgeries, 50% with saline and 50% with silicone gel implants. So, are these implants safe? According to an extensive FDA report, it appears that they are–unless of course you count the “frequent local complications and adverse outcomes.” Apparently, these necessitate removal of 5% of implants within the first two years and re-operation in up to 50% of cases within 10 years.

Less than pleasant, but are there any other problems with breast implants? Yes. First, it appears that breast reconstruction or augmentation is not a “permanent” procedure. It will need to be repeated and, of course, any surgery carries a risk.

But, on the positive side, implants do not appear to cause “connective tissue disease, breast cancer, or reproductive problems,” as was thought. To date the only disease that appears to be associated with them (both saline and gel silicone) is anaplastic large cell lymphoma, and the incidence is extremely low.

Interestingly, the problem found to be most significantly correlated to breast implants is a threefold higher risk for suicide attempts. Obviously, this is more likely to be attributable to the lack of self-esteem that made a woman consider cosmetic breast augmentation in the first place. It is probably not because the implant caused the suicidal behavior.

Therefore, assuming the psychological factors are in order, breast implants appear to be fairly safe. But, before you go out and get yourself a boob job, remember that the long term effects have not been fully studied. In addition, in attempting to do so, the FDA is relying on data gathered by the implant manufacturers themselves. From what is reported above with PIP, that may not be as impartial as one would wish. The primary manufacturers in the USA are Allergan and Johnson and Johnson’s Mentor. Their implant rupture rate appears to be about 6% over a period of ten years. Not great, but not as bad as PIP, where it was 15-30%. But then, how likely is it that the public (or even the FDA) are being  fully informed?

What is the take-home message for those considering implants? Think about it! Read the available information, ask questions, and decide for yourself. But, please, consider very carefully if your daughter might be better with something other than surgery to help her celebrate her 18th birthday.