Breast Implants Facts : Part 3

by Food and Drug Administration (FDA)

(Page 3 of 3)

Roth did survive — both breast cancer and two silicone breast implants gone bad. But the ruptured devices, she believes, caused her to lose her good health, her job, and eventually her health insurance over the next 11 years. "I found out the hard way," she says. "There were many risks with the implants that I didn't know about."

Other women are pleased with their implants. Clara Filion underwent reconstruction in 1993 after having a breast removal that included the lymph nodes under the arm (modified radical mastectomy) due to cancer. The 67-year-old Bedias, Texas, resident says she's thrilled with the outcome of her saline-filled implant, as well as with her surgeon, even though her original implant will need replacing soon due to scar tissue — a local complication that Filion says she always knew could occur. Filion has experienced no other complications related to the implant in 11 years.

Other Considerations

"My doctor told me that these implants would go with me to my grave," says 44-year-old Patty Faussett of Henderson, Nev., who chose to augment her breasts with saline breast implants in 1997, after years of breast-feeding distorted their shape.

Faussett had her implants removed a year after implantation because she believes they caused a mixed bag of health problems, including disturbed vision, heart palpitations, muscle twitching, and an autoimmune thyroid disease. She says, "The risks were much greater than my surgeon led me to believe."

Experts caution that breast implants do not last a lifetime. Women should be prepared for long-term follow-up and additional surgeries to treat complications. They also should be prepared for the accompanying additional costs. One of the biggest problems Faussett says she hears from women in her breast implant support group is that "most don't plan for the money it takes to fix what goes wrong."

In addition, women should be aware that hard pressure on the breast (compression) during mammography may cause implant rupture. Breast implants also can interfere with finding breast cancer during mammography. Doctors say the implant can hide breast tissue and, as a result, hide lesions as well. Extensive scarring and calcium deposits in tissue surrounding an implant can mimic the appearance of cancer, making the deposits difficult to distinguish from tumors on a mammogram.

Another consideration is the choice of a surgeon. Patient advocates, professional groups, and others agree that it's important to choose a plastic surgeon who has been trained in breast implant surgery and who has performed it successfully on many women.

After switching to a new, firmer silicone gel-filled implant through a clinical study only a year after experiencing rippling with her saline implants, Kathy Bracy says it's important that women who are considering breast implants do their homework.

"I love my breast implants, but I also spent six months researching the devices, which included picking the best doctor for me," says Bracy, a 38-year-old self-employed bookkeeper from Tampa, Fla. "It's not necessarily the product, but who is doing the surgery." The key to breast implant satisfaction, she says, is to "find a doctor who is willing to answer all your questions and take all your concerns seriously. And the relationship with your doctor doesn't end after the surgery."

Experts also advise women to have realistic expectations about breast implants. There is no guarantee that the results will match those of other women. Overall health, age, chest structure, the shape and position of the breast and nipple, skin texture, the tendency to bleed, prior breast surgeries, and the surgical team's skill and experience all figure into the outcome of breast implant surgeries.

The Teen Scene

In addition to safety issues, there is concern about the growing use of breast implants among teen-agers. Health officials worry that teen-agers and their parents may not realize the relative permanence of the changes caused by the devices. They also want to be sure that teens are physically ready — that is, they're finished developing — and that they are psychologically mature enough to handle the outcome of surgery.

"I didn't know my breasts were still growing when I signed up for the surgery," admits Kacey Long, who got saline-filled breast implants in July 2001, when she was 19. Prior to her surgery, the college student from Ennis, Texas, was a 34B — a breast size she thought would be with her for life.

Teen-agers who are dissatisfied with their bodies see breast implants as a harmless — and, according to Long, "fun" — thing to do to improve their self-image. Long says she felt that her body was too "bottom heavy" for her breasts and wanted to "even out" her figure. "But I never thought about my implants being dangerous," she says. A friend's mother worked for a plastic surgeon for 12 years and told Long she knew of no problems with patients who had gotten the implants. "I really thought that I had inside information, and that these devices were completely safe and maintenance-free."

Following implantation, Long went to a 34D. But complications convinced her to have the implants removed a short time later. "I had shooting pains in my arms, excruciating pain in every joint, bone, and muscle of my body, I was exhausted all the time, had no energy, lost my hair, and had pains in my chest, heart, and ribs. I had trouble remembering things and thinking clearly, and the list goes on," she says. "Before the implants, all I had was allergies."

Many of the changes to the breast that occur with an implant cannot be undone. If a teen chooses to have her implants removed, she may experience dimpling, puckering, wrinkling, or other cosmetic changes.

Three years later, Long's breasts measure 36C — one size larger than before she was implanted — suggesting that her own breasts continued to develop even after the implants were removed. "When you're making a decision that can impact your life at 19," Long advises other young women, "you need to research the subject like you're 50 years old."

Ongoing clinical studies for unapproved saline-filled and silicone gel-filled breast implants do not allow for those younger than 18 to receive the implants for augmentation purposes. Some of these clinical studies even limit reconstruction and revision uses to women 18 and over.

About the Author

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FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.