Since the announcement last year that some breast implants may leak toxic chemicals into the body, there has been a steady stream of worried women arriving at my hospital.
But the real concern is that we have not seen more.
The alarm was raised in France when surgeons noticed implants made by Poly Implant Prosthese (PIP) were rupturing, causing a raft of symptoms from immune system problems to debilitating pain, fever, rashes and extreme fatigue.
After an investigation the company was closed down by French authorities, which accused it of fraudulently using a non-approved silicone gel more commonly used in the manufacture of mattresses and pillows, for almost ten years.
About 8,000 British women a year have breast augmentation, most for cosmetic reasons, but many undergo reconstruction after a mastectomy.
Initially it was thought that 50,000 Britons may have been given PIP implants, but plastic surgeons now believe the figure could be 100,000. There are 2,000 names on a class action against the French company, and we, similar to most clinics, have seen a few hundred patients with PIP implants.
In most cases we tell them to watch and wait, as there is no reason to undergo major revisional surgery unless a rupture is found.
So far three patients have had symptoms and been found to have silicone gel moving freely within their breast. In these circumstances we take out the implant, clean the wound and put in a safer replacement.
Although it has been suggested only women who underwent cutprice surgery in overseas clinics were at risk, all these women had their implants fitted at UK clinics - some at supposedly reputable Harley Street firms.
Our hospital has never used PIP products. Quality implants cost upwards of £300 each, depending on the type, and the French company were selling theirs for a fraction of this.
There may be tens of thousands of women with no idea that they have a PIP implant.
Since the Nineties, every woman given a breast augmentation should have had the make, size and serial number of her prostheses given to her and recorded in the medical notes.
This is the only way to tell if you have a PIP implant, and I urge all women who have undergone a breast enlargement in the past 20 years to contact their surgeon to find out.
If a PIP implant was used, they should consider undergoing an ultrasound scan to detect if there has been any leakage.
All modern breast implants are made up of multiple layers of silicone shell filled with a silicone gel. The body normally reacts to a foreign object placed under the skin by building up a capsule of scar tissue around it, sealing it off from the rest of the body.
This can cause the implant to become hard or misshapen. The outer layers of today's implants are textured, a bit like felt, which helps prevent this from happening. Inside that is a tough layer that stops the implant from breaking, and an inner layer that is impermeable so the content can't leak out.
Silicone itself comes in a variety of forms, from oils to gels and hard rubber, which is often used in finger joint replacements, catheters and the lines of intravenous drips. In the right forms, the body doesn't react to it in an allergic fashion.
Some reports suggested that the problem with PIP implants, aside from the industrial-grade filling, was that protective layers were missing.
We are still awaiting the outcome of tests by the French authorities to determine what dangers the gel used may pose. The fear is that it could be carcinogenic.
The faulty implants were also sold under different names, including Rofil Medical M-Implant in Holland.
Those given PIP implants are at a risk of illness through no fault of their own, yet we have heard from patients that some GPs are refusing requests for ultrasound scans as the original procedure was paid for privately.
If we are to rescue the reputation of our profession, all private clinics must offer scans at a cost price of £50 rather than the usual £200 and offer corrective surgery if required at a reasonable cost.
And if any women have reason to think they might be at risk, they should act now before it is too late.
source: dailymail.co.uk
Link: PIP Implant Claims
