The Hidden Health Risks of Breast Implants

CC BY 2.0. Docteur Spitalier Philippe

This is serious surgery with long-term implications. We need to stop treating it so lightly.

Over the past two decades, the number of breast augmentations performed in the United States has doubled. It's now the most popular cosmetic surgical procedure in the country, with over 313,000 procedures happening in 2018. No wonder it's viewed as routine, and even advertised as such. Playful, joking ads compare tangerines to grapefruits and suggest that your augmentation is "a gift you can both enjoy."

But according to Amanda Mull in the Atlantic, this is a dangerous attitude. Breast augmentation should not be taken lightly. It's seriously invasive surgery, and although research has shown it to be safe, that's only when the implants are maintained properly – something that many clients fail to do.

Apparently many clients go in for augmentations, thinking it's a one-shot deal, but NYC-based plastic surgeon Jason Spector says he always tells clients that it won't be the last surgery they have on their breasts. Mull writes,

"Modern implants can require replacement less than 10 years after a patient’s initial surgery. The FDA recommends that patients have follow-ups with their doctors and MRI surveillance throughout the life of the implant, something that Spector says not all doctors insist on and not all patients adhere to."

Tens of thousands of women have complained about health problems linked to breast implants. They report chronic fatigue, pain, and autoimmune problems. Some develop scar tissue around the implant, causing pain and deformity. There is some evidence that the use of textured implants is linked to a rare cancer called anaplastic large cell lymphoma. One controversial study from 2018 found "a link between several cancers and autoimmune diseases and silicone implants."

Finally, after years of pressure from women's advocacy groups, an FDA advisory committee held a two-day panel discussion last week, during which it heard women's stories and consulted with plastic surgeons. The panel concluded by recommending that

"the FDA require manufacturers to provide simpler and clearer health warnings to all patients, but stopped short of encouraging a ban on any particular type of implants."

The information booklets shown to pre-op patients are long and confusing, with 70+ pages of legalese designed to protect manufacturers, so the panel requested simplified versions. Some advocates asked for 'black box' warnings on products, a two-page checklist and signed consent form, and an outright ban on textured implants (smooth ones are used in most U.S. procedures), but these were not recommended in the end.

While it's good to hear that risks are being discussed, it is unfortunate that the FDA is passing on so much of the responsibility to the (relatively uninformed) client. It should be, in theory, the FDA's job to eliminate risky procedures, but a Washington Post report shows that oversight is seriously lacking, with approved implant manufacturers failing to conduct the long-term health impact studies that they were ordered to do in 2006, when the 13-year ban on implants was lifted.

So, really, it's up to women to do their own research and to choose a conscientious doctor. Or, better yet, avoid the temptation to augment unless deemed necessary, i.e. post-mastectomy reconstruction. Obviously every woman will have her own reasons for wanting this surgery, but for the wellbeing of all, we need to stop treating it so lightly and respect it for the serious operation it is.