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16 février, 2008 13:36

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Myrl Jeffcoat

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New York Times Examines Duration Of Breast Implants, Health Risks Of Reoperation

The New York Times on Thursday examined whether breast implants are the kind of "annuity medicine" that will require routine surgical "tune-ups" and whether they expose patients to increased medical risk and unreasonable out-of-pocket expenses. Doctors in the U.S. performed about 329,000 breast augmentation surgeries in 2006, up from about 291,000 augmentations in 2005, a survey by the American Society of Plastic Surgeons found. According to the Times, the "renaissance" of breast enhancement surgery, the country's most popular cosmetic operation, has been fueled in part by FDA's decision in 2006 to approve a new line of silicone implants, lifting a 14-year moratorium.

There is "no established medical consensus" on how long breast implants last because available clinical studies follow patients for just a few years, the Times reports. Saline implants and silicone implants can develop small tears in their shells, causing ruptures. Implants also can cause scar tissue, which sometimes hardens and squeezes the implant, causing pain and deforming the breasts. In the case of defects, manufactures Allergan and Mentor offer warranty on the implants. Allergan provides a lifetime implant replacement warranty and up to $1,200 for fees for the first 10 years. One-third of patients in an Allergan study had a second operation within four years.

"The short answer is, we don't know specifically how long implants last," Stephen Li -- the president of a medical device testing company, who served on three of FDA's panels that reviewed implant safety and voted to approve silicone implants -- said. He said manufacturers' data indicate the implants should last at least 10 years. Carol Ciancutti-Leyva, the director of a 2007 anti-implant documentary called "Absolutely Safe," said that "implants may last less than 10 years or more than 10 years but when you start having problems with them, your health insurance is unlikely to cover the MRI tests or the reoperations."

In addition, "explantation" surgery, which involves complete removal of implants and scar tissue, can be complicated, particularly for older silicone implants, the Times reports. "If the envelope has broken down and the silicone has leaked out, you are trying to get out all of that goo," Susan Kolb, a plastic surgeon in Atlanta who performs three to five explantation surgeries weekly, said. Scar tissue can adhere to muscles and to the fibrous tissue covering the ribs, and some doctors mistakenly remove too much muscle or breast tissue during the surgery, which can cause chest deformities, she said (Singer, New York Times, 1/17).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.