According to the National Institute of Medicine, 25 to 40 percent of people who get breast implants end up needing another operation to correct something wrong with the first one. (The rate varied in particular studies, depending on things like how long women were monitored, the typical time being five years.)
2) A study by a maker of saline breast implants, Mentor, found that 27 percent of implants put into breast cancer patients had to be taken back out again within three years, due to side effects. Another 13 percent had to have lesser corrective surgeries. The competing manufacturer McGhan/Inamed/Allergan has similar numbers. Even for healthy patients, both were forced to admit that "most women experienced at least one complication over the three year period".
3) In general, breast cancer patients have complications with implants far more often than healthy people do. Many of the complications are about three times as likely for mastectomy reconstruction patients as for cosmetic augmentation patients. We regard this as socially the most acceptable and necessary time for implants to be used, but medically it is the most risky and unjustifiable time to use them. If you don't have a healthy body at the start when you're getting the implants, the odds of keeping healthy with them in place plummet.
4) Up to 9 percent of saline implants end up deflating within just three years, according to the Food and Drug Administration. The FDA also found that complications become more and more common for each year implants spend in the body.
5) Another FDA study found that even among women who had not complained of any perceived trouble with their implants, MRI scans showed two thirds of them have ruptured implants on at least one side. The rate was actually higher in 10 to 15 year old implants than with 20 year old ones, because the older ones were made with thicker containers. In 21 percent of women in the study, significant volumes of silicone were found to have migrated elsewhere in the body. Doctors removing implants often claim that they ruptured at the time of removal. This study makes me suspect, as some patients long have, that many doctors are lying about this for some reason, perhaps to avoid liability.
6) Though rare, it is not unknown for complications to be so severe that the breast ends up getting amputated. The chest wall can be injured. Your lungs and heart can be affected. You can end up dead.
7) They sometimes find cultures of microorganisms growing inside saline implants when they're removed. This is worrisome given that the newest implants contain vegetable oil... it could spoil. Saline, at least, is not a nutritious meal for bacteria. Even the silicone gel ones sometimes get some kind of mildewy looking stuff growing inside them... and each new fluid they've tried has been friendlier to microorganisms than the last one was.
8) If you're a European patient who has the option of oil-filled implants (these implants have not been approved in the US), British doctor Rahim Karjoo warns that oils leaking into the body will absorb calcium, and the resulting soaplike material, if it enters the bloodstream, can create fat emboli which can kill you without warning. The British government recently withdrew its approval for oil-filled implants and they will no longer be sold there.
9) Surgery in fatty tissues runs a much higher risk of difficult and dangerous infections taking root than surgery in lean tissue does. Infections with implants present are harder to treat than otherwise. In some cases the implant has to be taken out before the infection can be controlled. This problem affects about one breast augmentation patient out of 80.
10) So they replaced silicone implants with saline ones, avoiding the possible immunological problems associated with silicone gel leakage... and then the National Institute of Medicine decided that silicone has been "exonerated" and doesn't cause many of the problems it was accused of causing... So what -- somehow just about as many people have problems with saline implants as had trouble with silicone ones. The container is still silicone rubber, after all, which differs from silicone gel mostly just in the length of its molecules' polymer chains. Eventually, small flakes of silicone rubber come loose, and sometimes the chains break down chemically, yielding fluid silicone compounds, elemental silicon, and silica dust. (The operation often leaves stray talcum powder in the body, too.) The early silicone implants made by Dow Corning (now banned) simply allowed the interior gel to soak right through the containing capsule -- a fact that the company covered up. The implant container can also release traces of heavy metals like platinum (used as a catalyst in creating the silicone polymers) or lead, and carcinogenic solvents like xylene and toluene. A German study (J. Friemann, M. Bauer, et al) of the scar tissue surrounding removed implants found the tissue was commonly impregnated with chemicals from the implant, and also showed evidence of chronic inflammation occurring there. Some doctors believe that "capsular contracture", the most common side effect of implants, is directly caused by such an inflammatory response, meaning that the fraction of patients experiencing an immune reaction to the implants is quite large in proportion to the total population of recipients.
11) And if the official line is that silicone is now exonerated, then why isn't it okay to inject silicone directly into the body without a container around it, like they used to back in 1960? No doctor would try that now... they could land in jail. Some doctors are of the opinion that no facility that accepts blood or organ donations should take any from women who have silicone in their bodies, whether it's in a container or not.
12) The "exoneration" of silicone and implants is based on a failure to link it to certain autoimmune diseases that some implant patients were diagnosed with: arthritis, lupus, sclerodoma, etc. Interestingly, the same symptoms (sore joints, weak muscles, fatigue, cognitive difficulties) keep leading to different diagnoses, none of which was provable in itself. The obvious conclusion is that the condition is a separate disease that somewhat resembles these others. One theory is that many of these symptoms might be caused by ethylene oxide, which was used to sterilize many implants after they were manufactured, possibly contaminating the material. Another is that the common cause is an allergic reaction to the presence of traces of platinum. The studies also found no link with breast cancer... but overall cancers were another matter. Two recent NIH studies of overall mortality of women with implants, one from the National Cancer Institute (Dr. Louise Brinton) and one from the FDA, found plenty of extra mortality relative to patients of other plastic surgeries. Causes included lung cancer, brain cancer, a few other cancers, other lung diseases, and an increased rate of suicide. Finally, the important point to note about the dozens or hundreds of studies that supposedly show that silicone implants are safe is that not one examined a period longer than the initial three years after implantation.
13) One of the fastest growing areas of medical practice is surgeons who specialize in repairing the errors and complications of boob jobs done by other doctors. "If a doctor tells you they don't have complications, they're either not operating or they're lying to you," says Dr. Jack A. Friedland of Scottsdale.
14) A lot of doctors doing boob jobs and other vanity surgery are half-assed quacks without proper qualifications. Most states allow anyone with a medical degree -- even dentists -- to take a weekend course and sell plastic surgery. They do it because it's easy money. Dr. Ervin Moss of New Jersey says, "You can't imagine how many specialist groups are lobbying against [laws requiring proper accreditation] as a threat to the bottom line."
15) Can you imagine your doctor brushing off life-threatening complications and telling you "You look great!" when you ought to be heading for the emergency room? It's been known to happen in the cosmetic surgery biz...