A Plastic Surgeon Sees Trouble Ahead

By Christine Cupaiuolo — January 19, 2007

Apologies for not posting yesterday due to technical trouble. Here’s Thursday’s post with a double dose to follow shortly.

Edward Melmed, a Dallas surgeon, has written one of the most convincing essays I’ve come across about the dangers of silicone breast implants. His recent op-ed in the Los Angeles Times opens with the subject line of an e-mail he and thousands of other surgeons received in November from a breast implant manufacturer: “Let’s toast this monumental occasion.”

The reason for such joy? The FDA decided to allow silicone breast implants, which were banned in 1992, back on the market.

Melmed said he’s one plastic surgeon who isn’t pouring champagne. After three decades of enlarging women’s breasts, Melmed reevaluated his pro-silicone position in the early 1990s when women started coming to him complaining of hardened and painful breasts. Here’s his experience:

In the last 14 years, I have removed implants from almost 1,000 women. I have found roughly 50% of their implants have ruptured within 10 years, and more than 70% have ruptured within 15 years. We are still not sure of all the places where the micro-droplets of silicone end up, though I have found it in lymph nodes. […]

Most plastic surgeons vehemently deny any connection between health complaints and leaking silicone implants. But I have seen a disturbing number of patients with symptoms, including fatigue, short-term memory loss, joint and muscle pains, skin rashes, disturbed sleep patterns, depression and hair loss, that clear up when implants are removed.

Last year, I completed a review of the last 500 gel implant removals I performed, and found that more than half the women had similar symptoms, ranging from mild to debilitating. According to the manufacturers’ own literature, one in four women has additional surgery within the first year. Many women have multiple surgeries.

“Women deciding to have these implants need to be prepared to have additional surgery,” cautioned Dr. Daniel Schultz, head of the Center for Devices and Radiological Health at the FDA.

The FDA is requiring manufacturers to spend 10 years studying 80,000 women who receive the implants. Apparently our government’s policy has become, “Approve now, test later.” At current implantation rates, these devices will be in the bodies of 5% of U.S. women within a decade. As I now see it, grossly outsized artificial breasts are a deformity that flouts medical standards and even the plastic surgeons society’s own definition of “cosmetic” — all too often encouraged by the media, which celebrates these water balloons for self-esteem.

Though I do approve of the use of implants for breast reconstruction, when there is no other option, I no longer perform cosmetic breast augmentation. But let’s raise a glass of bubbly for the manufacturers and the plastic surgeons. This will be a happy and prosperous year, for them.

Plus: Need more background? Our Bodies, Ourselves has quite a bit of information about silicone implants.

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