PATTI FLINT MD
I am a firm believer in the benefits of free speech, but as it relates to science, I do believe authors should have to provide a scintilla of evidence that what they are professing to be true is based in scientific fact. Alas the internet does not have any such requirements, and as such, I am seeing more and more women who are really scared that their breast implants may be causing myriad health problems. Thankfully this concern is unwarranted in the vast majority of cases.
First, a little history is in order. In 2006, the head of the FDA proclaimed publically that breast implants were the most studied medical device. This happened after the breast implant “crisis.” In January 1992 the FDA put forth a voluntary moratorium on the use of silicone breast implants in aesthetic surgery so that further study on safety could be undertaken. (Keep in mind these implants had been in use since the early 1960’s.) In 1999, the Institute of Medicine published a 400 page report proclaiming after exhaustive review of existing data, there was no causal link between auto-immune disease and silicone breast implants. Those of us who practice Plastic Surgery breathed a sigh of relief. While we suspected this was true, we were all happy to hear we had remained true to our oath of first do no harm. Subsequently in 2006 the moratorium was lifted and silicone implants came back to market.
The implant manufacturers were required to perform ten year studies to provide on-going data on women with newer generation silicone breast implants. That data also supported no link between auto-immune disease and silicone implants. It is a bit regrettable that the data collection stopped there, as additional longer term data is desirable. That was not done for a variety of reasons including lack of a requirement by the FDA, lack of patient compliance with follow-up, and significant cost to the manufacturers.
Why then is there SO much chatter on the internet about breast implant associated illness? Because women are worried and they talk about their concerns in chat rooms. They are not always aware of or privy to the scientific data. The demographic of women who choose to get breast implants closely match the demographic of women who frequently are stricken with auto-immune diseases. However, that does NOT mean a causal link exist, and currently available scientific data proves there is not one. In fact, there was data published some time ago that followed women that had auto-immune disease that chose to have their implants removed. One third got improved, one third remained the same and one third had a worsening of their symptoms after removal. These outcomes are closely matched to women who have auto-immune disease and have never had breast implants.
Most importantly, if you have breast implants and you are concerned about any symptoms or something you have heard or read, contact your plastic surgeon. He or she will be an excellent source of information that is based in fact so that you can make an informed decision about your implants. If you are considering having breast augmentation, consult with a board certified plastic surgeon, NOT Dr. Google or a “cosmetic surgeon.” Get the facts and then carry on! I truly believe that silicone breast implants are safe. I cannot predict the future, but we have a LOT of data on these devices, and I am confident I am staying true to my oath.
