No health concerns with silicone implants

To the editor:

In response to Paul Harasim’s April 1 article, “Silicone or saline argument goes on,” about the recent approval of silicone breast implants by the FDA:

After 14 years of study, including 80,000 women in the United States and more than 1 million women worldwide, silicone breast implants are considered to be the most extensively studied medical device in the history of the FDA. The data used by the FDA in its decision is readily available to the public and includes numerous peer-reviewed articles by physician researchers representing multiple medical specialties. This includes the 400-page, landmark 1999 report by the National Institutes of Health’s Institute of Medicine, which concluded that, “A review of the toxicology studies of silicones and other substances known to be in breast implants does not provide a basis for health concerns.”

Many points that are public knowledge are not discussed, such as the fact that silicone implants were never taken off the market in Europe or South and Central America, where they remain the most commonly used implant.

Silicone is ubiquitous in our society and is part of many implanted medical devices (pacemakers, artificial hips, heart valves and even pacifiers). It is also very important to note that the currently used silicone gel implants are vastly superior to the implants that are often discussed with patients, such as the patient referred to in the article. There has not been a well-conducted study that has ever proven a correlation between silicone and illness of any kind.

Complications of breast implants are local in nature and include firmness of the scar that forms around the implant, and sometimes unhappiness with your post-operative result. Currently used silicone implants, which have been used for more than the past 15 years, have a thicker shell which will withstand 25 times the force of a standard mammogram without failure. They also feature an additional barrier layer and the gel inside is more cohesive — meaning it has the consistency of Jello, which lends to its more natural feel when implanted.

Breast augmentation was the most commonly performed cosmetic surgical procedure in women in 2006, surpassing liposuction. According to the statistics gathered by the American Society for Aesthetic Plastic Surgery, 42 percent of these women were 35 to 50 years old, so it is not just a procedure for younger women. Women seek breast implant surgery for a variety of reasons, including restoring their breast size and shape following significant life events such as childbirth and breast-feeding. The approval of silicone should be considered a positive event for women, allowing them to make an intelligent and informed choice about what device they would like to use.

I tell patients that if they have any concerns about the use of silicone, I would prefer that they have a saline-filled implant. It is my job to educate my patients and provide the best care possible, not to push them toward the use of one implant or another.

Michael C. Edwards, M.D.

LAS VEGAS

THE WRITER IS A PHYSICIAN SPECIALIZING IN PLASTIC AND RECONSTRUCTIVE SURGERY.