Breast implants - all in the upkeep
28 December 2011, 12:42
London - The internet and women's magazines are filled with
enticing adverts for breast implant surgery, but experts and regulators
have varying views on how long they last and possible risks.
implants now at the centre of a worldwide health scare came from the
now-defunct 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, after the first implants were developed
by two plastic surgeons in Texas working with the silicone specialist
firm Dow Corning Corporation.
The first woman to have
silicone breast implants was in 1962 in the United States. Since then,
between 5 and 10 million women worldwide, including an estimated 1.5
million to 2.5 million in the United States, have had breast implant
Although silicone implants are considered the more
natural-looking option because they are more likely to appear and feel
like real breasts, safety concerns have dogged them for years.
In 1992, the US drugs regulator, the Food and Drugs Administration
(FDA), decided silicone implants should be taken off the domestic market
because their safety had not been fully established.
silicone implant sales resumed in 2006 after the FDA approved implants
sold by Allergan and Johnson & Johnson's Mentor unit on condition
that the companies would follow a sample of 40 000 women for 10 years to
look at safety issues.
In Britain, breast enlargement is
the most common cosmetic surgery performed on women, the Medicines and
Healthcare products Regulatory Agency (MHRA) said.
operation is also hugely popular in Latin America. In Brazil, some 200
000 to 300 000 breast implant operations are carried out each year,
according to the Brazilian Plastic Surgery Society.
Natural or fake
Several types of implant are available, including those constructed
from natural tissue taken from elsewhere on the body. This type of
surgery is more usual in breast cancer patients undergoing breast
reconstruction after a mastectomy.
More common implants used in
cosmetic surgery are silicone- or saline-filled devices which are placed
under the breast tissue to boost size and enhance shape.
implants are usually inserted via an incision under the breast, but can
also be put in using a cut in the armpit or around the nipple. The
operation is generally done under general anaesthetic and takes up to
Experts warn, however, that breast implants are likely to need long-term care.
"Breast implants do not last a lifetime, they will need replacing at
some point in the future," the British Implant Information Society says
on its website.
It says modern devices 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 - in Venezuela it is
not unusual for parents to give breast implant surgery to teenage
daughters as gifts - this could mean a woman going back once and
possibly twice in a lifetime for more breast surgery.
say pain is frequent after surgery, and most clinics advise patients not
to raise their arms above their heads for several weeks after the
Creasing and kinking
lists other potential problems, such as the risks of infection, leakage
or bleeding, possible creasing and kinking of the breast tissue, and
temporary loss of sensation.
US regulators warned this year that
most women with implants were likely to need additional surgery within
10 years to address complications such as rupturing and leakage, two of
the main problems associated with the PIP devices.
All this suggests the costs of breast enhancement surgery are likely to add up over the years.
According to one US cosmetic surgery price guide, breast implant
surgery with either silicone or saline implants can cost between $5 000
and $8 000, similar to costs in Britain.
breast surgery is often more expensive, lengthier and more complicated
than the first time around because of existing scar tissue and the need
to remove or adjust the original implants.
significantly lower priced surgery may be cutting corners on after-care
or follow-up consultations, experts say, and patients should beware.