Dr Rajendra S Rampaul
Breast implants are becoming very popular in the cosmetic world and have been around for over 20 years. It is well known that a lot of women in Latin America and North America seek to have cosmetic implants.
It is also well known to the general public that implants are an instrumental part of breast reconstruction following breast cancer surgery, and it allows a women to retain her breast form after operations like mastectomy (removal of the entire breast).
Cosmetic implants and reconstructive implants are usually the same and are made of a silicone shell with liquid silicone inside. (The use of saline is on the decline).
Many readers will be aware of the recent scandal coming out of PIP (France) implants where industrial grade silicone was used within the implant exposing the patient to the potential risk of having a leak industrial grade silicone within their body.
This is pretty much the stuff that is used in cars, motor oils, and sealing glass windows. That’s scary stuff, no doubt. However, it should be appreciated that high quality medical silicone is very different from this.
It is difficult to understand why the manufacturers in France chose to break all the regulatory guidelines and seek to use a much cheaper grade. However, there has been a worldwide recall of these types of implants.
Not surprisingly, many Latin American countries such as Venezuela have found themselves in a difficult position where almost all plastic surgeons who have exclusively used PIP implants due to their low cost now have to face the embarrassing situation of telling patients they have to return for further replacement surgery with a better grade of implant.
There are very robust and safe implants and these usually carry the CE mark (Europe) or the FDA (US) approvals. These are safe within the body and have been shown to be without side effects even if there is a leak. However, it does bring us to the very question that we are trying to explore in this article which is what happens if there is a leak or ruptured implant.
In general, two things tend to happen—one is that the leak is contained by a capsule that forms around the body and there is no general seepage of the liquid silicone into the body. Sometimes that liquid silicone can seep into the body but often will cause no harm.
It may affect your lymph nodes, which are glands under the arm, and cause them to become enlarged. This is often detected when you see your doctor. They are often palpable like little lumps or they show up on ultrasound with a ‘snow-storm’ appearance.
Free flowing silicone in the body does not cause cancer however, it is uncomfortable and can incite reactions that can disfigure the breast, hence it is usually recommended to replace these implants.
High quality implants carry a very low rate of leak. I recommend to all my patients on whom I perform cosmetic or reconstructive implant based surgery to have it checked annually, or I may often scan them within the first three years. Thereafter, it is safe to not do any active surveillance.
Most modern implants do not require a shelf life and therefore do not require routine exchange after ten to 15 years and can last a lifetime. I would advise that you routinely check with your plastic or breast surgeon when you have had these devices inserted.
An important point to note is that implants do not raise your risk of developing breast cancer nor does it hide breast cancer if it develops. You are also able to do a thorough breast examination, mammography and ultrasound without any hindrance from these devices.
Dr Rajendra S Rampaul
Breast and
Reconstructive
Surgeon,
Surgical
Oncologist
Pink Hibiscus,
Adam Smith Square,
Woodbrook • 627-1010
www.pinkhibiscustt.com