Category Archives: Have Questions?

How Obamacare can help women with breast implant problems!

For years we have heard from women with leaking breast implants and other serious implant problems who want to get their implants removed but can’t afford it.  Breast cancer patients who have health insurance have been covered but augmentation patients have not.  And, breast cancer patients who couldn’t afford health insurance (and there are many) were also out of luck.  Many women who have been in this situation or might be in the future will find that Obamacare is a great help! We encourage women to take advantage of the law while it is still in place, because it might be repealed or substantially changed in the future.

  • Under Obamacare, health insurance companies can’t refuse to pay for health problems related to a pre-existing condition.  Before Obamacare (the Affordable Care Act), many insurance companies considered breast implants a pre-existing condition.  Under Obamacare, insurance companies are generally required to pay for services that are medically necessary, even if the reason for the health problem is a pre-existing condition.  However, some insurance companies may try to exclude any services related to complications from cosmetic surgery, so read the policies carefully before you choose.
    • California, Florida, Massachusetts, New York, North Carolina, Texas, and Washington tend to be especially good about coverage for medically necessary services, even those related to previous cosmetic surgery. Medically necessary services usually include removal of leaking silicone gel breast implants, as well as removal of implants causing severe capsular contracture, serious infections, chronic pain, ALCL (a rare cancer of the immune system), or other serious health problems that a doctor says are caused by implants.
  • The State Insurance Exchanges offer health insurance policies that will be better and more affordable than most policies available to individuals who aren’t insured through their workplace.  It is important to go to www.healthcare.gov and look into the plans offered on your state’s Exchange. If you have lost an existing health insurance policy because of a change in marital status or job or other reasons, you can sign up for the exchange now – otherwise, the only time to sign up is between November 1 and December 15, you can get coverage starting January 1, 2018.  You will find pricing information for 2018 on the website. The lower your income, the less you will have to pay for these health insurance policies.  Check out the choices you have in your state on www.healthcare.gov and sign up as soon as you decide and definitely before Dec. 15, 2017 if you want to start your health insurance on January 1.  And make your appointment now for January surgery, if you need it!
  • To make sure that the policy you plan to buy includes implant removal or other coverage for the kind of implant problems you have, ask that question BEFORE you buy the policy.  If they can’t answer your question or tell you it would not be covered, please contact us immediately at info@center4research.org.  We will do our best to help.
  • In many states, Medicaid is available for free to any individual or family under 133% of the poverty line (that’s about $30,000/year for a family of 4).  Medicaid must provide coverage for pre-existing conditions and so it should include surgery or services that a doctor considers medically necessary, such as removing leaking silicone gel breast implants, implants causing chronic pain or infections, and other serious health problems.   If you are on Medicaid or Medicare and have problems getting this coverage, please contact us immediately at info@center4research.org .

 

What if I need to get my implants removed?

Q: What if I need to get my implants removed?

A: We’re not doctors and we don’t provide medical advice, but I can tell you what we know based on research and from speaking with many experts and with women who have had breast implants.

Women who have implants sometimes decide to have them removed because of complications, disappointment with how they look or feel, or concern about the long-term health risks. Some surgeons discourage patients from removing their implants. This may be because they don’t share the patient’s concerns, or because they believe that patients will be very unhappy with their appearance after the implant is removed.

The plastic surgeon who performed the original surgery is often not the best choice for removing implants. Removal can be much more complicated and expensive than the original surgery, especially after a silicone gel implant has broken. Some plastic surgeons are very experienced at removal and are especially skilled at getting the best possible cosmetic result.

It is essential to choose a plastic surgeon who specializes in removal.  He or she will probably want to remove the implants “en bloc,” which means that the implant and the intact scar tissue capsule surrounding it are all removed together. This helps remove any silicone that may have leaked from a broken gel implant, and also helps remove silicone or other chemicals that may have “bled” from the silicone outer envelope of a saline or silicone breast implant.

If the implant is removed from a healthy breast, ideally the plastic surgeon will also do a breast lift at the same time, so that the breast will not be saggy.

Breast Implant Removal

An example of saggy breasts

It is important to remove ruptured silicone gel implants as quickly as possible.  Women with ruptured silicone implants often lose breast tissue as part of the removal surgery, and the longer the implants are leaking, the more breast tissue the woman is likely to lose. If silicone has leaked into the breast tissue, the resulting removal surgery may be similar to a mastectomy. (See photo below.)  You can avoid that if you have your leaking silicone gel implants removed en bloc and before they leak a lot.

Photos of what happens when removing silicone deforms the breast. Click for larger view.

Photos of what happens when removing silicone
deforms the breast. Click for larger view.

Want your Breast Implants Removed- (2)

The comments and statements of the National Center for Health Research are believed and intended to be accurate, and where applicable, based on scientific literature. NCHR’s statements do not constitute medical diagnoses, medical advice, plans of treatment, or legal opinion, and we are not responsible for the use or application of this information. All medical information should be reviewed with your health care practitioner.

We hope that the information we’ve provided is helpful. In order to maintain this free service to all women and their families, we invite your tax-deductible contributions to NRC (see http://center4research.org/contribute/)

 

 

I have been diagnosed with breast cancer. What are my options so that I can still have breasts?

Q. I have been diagnosed with breast cancer. What are my options so that I can still have breasts?

A. We’re not doctors and we don’t provide medical advice, but I can tell you what we know based on research and from speaking with many experts and with women who have had breast implants.

If you have been diagnosed with early stage breast cancer (stage I, IIa, IIb, or IIIa) , you probably can keep your breasts, and have a lumpectomy rather than a mastectomy (which removes the entire breast). Early-stage breast cancer patients who undergo a lumpectomy (which removes only the cancer and a small area around it) that is followed by radiation will live just as long as women who have a mastectomy instead. The experts recommend a lumpectomy with radiation for most women because it is less traumatic physically and emotionally, and avoids the problems from reconstructing a breast. For more information about this, see a booklet printed by the National Cancer Institute, the NIH, AHRQ, and the National Center for Health Research at http://www.stopcancerfund.org/t-breast-cancer/a-booklet-for-patients-surgery-choices-for-women-with-early-stage-breast-cancer/ .

If you have been diagnosed with a pre-cancerous condition such as Stage 0 breast cancer, including ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS), it is very unlikely that you need a mastectomy. Women with LCIS do not have breast cancer and most will never get breast cancer. They do not need a mastectomy or even a lumpectomy, although they do need regular mammograms. Most women with DCIS can choose lumpectomy with radiation, rather than mastectomy. For more information, see http://www.stopcancerfund.org/in-the-news/free-patient-booklet-on-ductal-carcinoma-in-situ-dcis-2/

For women with breast cancer who want to have breasts, the preferred choice is usually to keep their breasts (rather than remove their breasts and create new ones). Although a lumpectomy can make the breast smaller or change the shape, it will still have the sensation of a natural breast. In contrast, a woman who has a mastectomy with reconstruction, either with implants or with tissue transferred from elsewhere in her body, will have “breast shapes” that do not have any feeling. They are numb. Reconstruction also requires at least two surgeries. Reconstructed breasts may look fuller or “younger” but when the options are explained to them, many women would prefer to have sensation in their breast (or breasts), and would prefer not to have to worry about complications and the need for additional surgery.

If a woman needs to have a mastectomy, because the DCIS has spread throughout the breast or the cancer is large, there are several choices for reconstruction: saline breast implants, silicone breast implants, and moving tissue to create a new breast, such as a TRAM flap (Transverse Rectus Abdominis Myocutaneous flap) or DIEP flap (Deep Inferior Epigastric Perforator flap).

Many plastic surgeons know how to reconstruct breasts using breast implants, but few are skilled at moving tissue (which is called autologous tissue transfer). That is one of the reasons why so many plastic surgeons recommend breast implants.

Saline or Silicone? Some surgeons prefer silicone gel breast implants to saline, because they feel more natural. However, saline breast implants are approved by the FDA as “reasonably safe” and silicone gel implants are not. That is why women getting silicone gel breast implants must agree to be in a study. The goal is to find out how many complications or problems arise in these women in order to decide whether they are safe enough to approve. You would be part of an experiment to find out if the implants are “safe enough” for other women.

One problem with silicone breast implants is that they can break without a patient knowing it. Although less embarrassing than an instant deflation (which is likely with saline), breakage without symptoms is a bad thing, not a good thing. If silicone gel breast implants break and leak, the silicone can get into lymph nodes and travel to the lungs, liver, and brain. No research has been done on those risks, but a study by scientists at the National Cancer Institute found that women with breast implants were twice as likely to die from brain cancer or lung cancer compared to other plastic surgery patients. More research is needed, but those findings are cause for concern.

If saline implants break they are usually easy to remove. If silicone implants break, they can leak and can be extremely difficult and expensive to remove carefully. For that reason, we believe that saline are safer than silicone, even though both have very high complication rates.

Risks. All breast implants, even saline implants, are enveloped in an outer shell made of silicone. The envelope also contains other chemicals and heavy metals, such as microscopic amounts of platinum or tin, which vary during the manufacturing process. Unfortunately, some women have a reaction to those substances. Although silicone is considered “biocompatible” and most people don’t have an immediate allergic or autoimmune response, some people do, and many more develop a response years later.

It’s impossible to predict who will have problems with breast implants, and who won’t. It’s important to know that all implants will eventually break, sometimes within a few months or years, and usually within 10 years. Sometimes women who have a mastectomy get breast implants to replace one breast and to make the other breast look more similar to the replaced breast. However, it’s important to know that either silicone or saline breast implants interfere with mammograms. They show up white on the film, hiding tumors that are above or below.

Alternatives to Implants. An alternative to breast implants is “autologous tissue transfer,” such as the TRAM flap and DIEP flap procedures. These procedures use a woman’s own fat and tissue is used to reconstruct the breast. Many women prefer it to implants because it feels more natural and apparently lasts for a very long time (possibly forever, although the procedure has mostly been done in the last 15 years so it’s impossible to say). However, both the TRAM flap and DIEP flap procedures are more expensive than implants, require an especially skilled surgeon for a good result, and the healing process usually takes at least several months and can be painful. Women are only able to get this surgery if they have enough body fat in their abdomen area or back to form breasts. And, like a breast implant reconstruction, the breast has no feeling. For a woman who has the tissue transferred from her abdomen area (in an operation that has been compared to a “tummy tuck”), there is some loss of muscle in that area. That can be a problem for athletic women, but many other women don’t mind.

The DIEP flap is a similar type of reconstruction but does not remove any muscle. Instead, for the DIEP flap, the surgeon only removes fat and other tissue and makes a small cut in the abdominal muscle. Since no part of the abdominal muscle is removed, patients are able to maintain abdominal strength, making this surgery a better option for most women, especially those who are physically active.

Fortunately, TRAM flaps and DIEP flaps are covered by some health insurance companies. These are complicated surgeries with long recovery times and you would need to find a physician who is very experienced doing these procedures, and we highly recommend asking the doctor to put you in touch with other patients who were happy with the reconstruction.

Latissimus Dorsi Flap Surgery. Reconstruction using the latissimus dorsi muscle usually combines a breast implant with autologous tissue from your own body.  In a way, this is the worst of all worlds: the risks, complications, and cost of autologous tissue surgery with the risks and replacement costs of breast implants.  Some surgeons offer it because they do not have the skills to do a DIEP.  If you want a natural, long-lasting reconstruction, we suggest you keep looking to find a surgeon who is experienced with DIEP.

In a latissimus dorsi flap procedure, an oval flap of skin, fat, muscle, and blood vessels from your upper back is used to reconstruct the breast. Keep in mind that the fat in that area feels stiffer than breast fat skin on your back usually has a slightly different color and texture than breast skin.  The surgery can cause a partial loss of strength or function that makes it hard to lift things and twist, and can affect your ability to swim, golf, or play tennis.

For more information about the risks, see here:  Latissimus Dorsi Flap Surgery Risks

The comments and statements of the National Research Center for Women & Families are believed and intended to be accurate, and where applicable, based on scientific literature. NRC’s statements do not constitute medical diagnoses, medical advice, plans of treatment, or legal opinion, and we are not responsible for the use or application of this information. All medical information should be reviewed with your health care practitioner.

We hope that the information we’ve provided is helpful. In order to maintain this free service to all women and their families, we invite your tax-deductible contributions to NRC (see http://center4research.org/contribute/)

My implants are making me sick. Can someone help pay for implant removal?

Q. My breast implants might be making me sick. Can someone help me afford medical care or help pay for implant removal?

A. We’re not doctors or lawyers and we don’t provide medical or legal advice, but we can tell you what we know based on speaking with many experts and with women who have had breast implants.

Lawsuits?

There are currently no class action suits for implants and individual suits are almost impossible. For more than 20 years, women have been asked to sign informed consent forms prior to implant surgery that are designed to protect the implant company and the physician.  Unfortunately, that means that most women who have gotten implants since then can’t sue unless the doctor committed malpractice.

There have been several class action legal settlements to provide compensation to women whose implants ruptured or caused medical problems; however, the deadlines for these settlements have passed.

Health Insurance?

Until recently, it was almost impossible to get health insurance companies to pay for removal of breast implants.  However, thanks to the Affordable Care Act (Obamacare), insurance companies can’t refuse to remove implants because the woman already had the implants when she got the insurance policy, for example.  We don’t know of any insurance companies that will replace breast implants for augmentation, but some companies will pay to remove implants that are leaking or causing serious medical problems. For more information on insurance coverage, click here.

If you would like help trying to get your insurance company to cover your breast implant removal, please fill out this very short survey, and we will try to help you: https://www.surveymonkey.com/s/KHCWGM8  We cannot guarantee that you will receive coverage, but we are here to help you with the process of trying to get coverage.

Financial Assitance Programs?

The Common Benefit Trust has established a program to provide financial assistance for explantation surgery on behalf of women who meet certain eligibility requirements.  This assistance is in the form of a direct payment of up to $5,000 to the plastic surgeon who performs the removal surgery.  There are eight requirements that must be met in order to be eligible for this assistance.  The first requirement is that you must have at least one silicone gel-filled or double lumen type breast implant in your body that was implanted before December 31, 2006.

In order to find out how the Explant Financial Assistance Program works, learn about the eligibility requirements, and express your interest in receiving this assistance, please visit www.explantassistance.com and www.oplc.org.  If you have any questions, feel free to contact the Program Administrator at jcondra@oplc.org, or (205)252-6784.

Want your Breast Implants Removed- (2)

The comments and statements of the National Center for Health Research are believed and intended to be accurate, and where applicable, based on scientific literature. NCHR’s statements do not constitute medical diagnoses, medical advice, plans of treatment, or legal opinion, and we are not responsible for the use or application of this information. All medical information should be reviewed with your health care practitioner.

We hope that the information we’ve provided is helpful. In order to maintain this free service to all women and their families, we invite your tax-deductible contributions to NCHR (see http://www.center4research.org/contribute.html)

I am a teenager thinking about getting breast augmentation. What can you tell me to help me decide?

Q. I am a teenager thinking about getting breast augmentation. What can you tell me to help me decide?

A. We’re not doctors and we don’t provide medical advice, but I can tell you what we know based on research and from speaking with many experts and with women who have had breast implants.

It is great that you are doing research about breast implants. Although it may seem that you are “done developing” that is often not true. If you have breast augmentation as a teenager, the implants could interfere with your normal development, or the resulting size and shape could be not at all what was intended as the breasts continue to develop. Women can continue to develop after age 20, and most will have more cleavage because they will gain a few pounds in their late teens and early 20’s. (In college, this is called the “Freshman 15” but it can happen whether you are in college or not, and not necessarily in the late teens.) Statistics show that most women who have breast augmentation are thinner than average. If they wait until they gain weight a few years later, they may no longer need or want augmentation.

Some women do fine with breast implants, while others have complications or health problems that can interfere with their lives. You might have read about Kacey Long, who was featured in Parade Magazine, People, and on MTV’s I Want a Famous Face. Kacey was 19 when she got saline breast implants and 21 when she had them removed. She got sick very quickly, but didn’t realize her health problems were related to her implants. She started spending all her time in bed, and was in too much pain to even comb her hair. However, when her implants were removed she immediately started to feel better. And, she also discovered that she had grown one cup size – so that when her implants were removed she was exactly the size she had wanted to be. Unfortunately, she is still paying for the augmentation surgery, since she bought the surgery on an installment plan. She was lucky to be able to borrow money from her family to have her implants removed.

You can read about Kacey and other personal stories of women who have had implants. Click here to read about another woman who got her implants when she was young and what she thinks of them today.

You can get more information about implants by checking out our website at at http://www.breastimplantinfo.org/what-you-need-to-know/. Although we believe saline implants are safer than silicone, both have a very high complication rate.

The comments and statements of the National Research Center for Women & Families are believed and intended to be accurate, and where applicable, based on scientific literature. NRC’s statements do not constitute medical diagnoses, medical advice, plans of treatment, or legal opinion, and we are not responsible for the use or application of this information. All medical information should be reviewed with your health care practitioner.

We hope that the information we’ve provided is helpful. In order to maintain this free service to all women and their families, we invite your tax-deductible contributions to NRC (see http://www.center4research.org/contribute.html)

After years of being unhappy with my breasts, I am thinking of getting breast implants. I am healthy and want to stay that way. What are the risks?

Q. After years of being unhappy with my breasts, I am thinking of getting breast implants. I am healthy and want to stay that way. What are the risks?

A. I’m not a doctor and we don’t provide medical advice, but I can tell you what we know based on research and from speaking with many experts and with women who have had breast implants.

Breast augmentation surgery has risks, but the risks are much greater for some women than others. According to implant makers’ patient booklets, implants are not recommended for women with any of the following:

• Active infection anywhere in your body

• Autoimmune diseases (such as arthritis, lupus and scleroderma). (If family members have these diseases, that can put you at higher risk also)

• Conditions that interfere with wound healing and blood clotting

• A weakened immune system (such as currently receiving immunosuppressive therapy)

Women who have breast cancer in their family are often concerned when they learn that implants can hide cancerous tumors. Saline and silicone breast implants show up as solid white shapes on a mammogram, hiding any tumors above or below. The latest research finds that half of the breast tissue (and half of the tumors) are obscured by breast implants, even when specially trained technicians use additional mammogram views for women with implants.

Even younger women have found that their implants interfere with an early diagnosis. Survivor star Jennifer Lyon died of breast cancer at age 37 in early 2010. According to Jennifer, in 2004 “I felt something in my right breast that didn’t feel normal. I thought it was probably scar tissue related to my breast implants. So I let it go — for a long time.” Jennifer was diagnosed with late-stage breast cancer two months after the tenth season of ‘Survivor’ wrapped in 2005.

All breast implants, silicone or saline, have high complication rates. Research conducted by implant manufacturers and analyzed by the FDA finds that most women have at least one serious complication within the first 3 years. Two of the most common are capsular contracture (which causes breast hardness and pain) and the need for additional surgery.

Most women like the way the implants look and feel for the first few years, but after that many find their implants look less natural or start to feel too firm or hard, and can be very painful. If an implant breaks or causes pain, surgery is necessary – but we hear from many women who can’t afford to pay to have their implants surgically removed. Unfortunately, surgery to fix implant problems can cost more than the augmentation itself. That is why we urge women not to have augmentation surgery unless they have at least an extra $5,000 in savings that they can put away and not spend until they need additional surgery.

The biggest controversy about breast implants is whether they can cause diseases or symptoms that are not in the breast area. We have talked to many implant patients who describe “flu-like” symptoms, or their joints hurt, or their hair started falling out. That’s what happened to Kacey Long, who was featured in Parade Magazine and on MTV’s I Want a Famous Face. Kacey was 19 when she got implants and 21 when she had them removed. She got arthritis and could barely get out of bed, but didn’t think it was related to her implants. However, when her implants were removed she immediately started to feel better.

You can get more information about what to expect if you get implants by checking out our website at http://www.breastimplantinfo.org/before-you-get-implants/.

You can also read some more personal stories of women who have had implants, including Kacey’s story, on our website at http://www.breastimplantinfo.org/personal-stories/ and you can look at some photos of common implant problems at http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm064106.htm.

When studies include women who have implants for just a few months or years, the women seem quite healthy. However, one study by NIH scientists found that women with breast implants for at least 12 years were twice as likely to die of brain cancer, lung cancer, or suicide, compared to other plastic surgery patients. A Canadian study found that women with breast implants were more likely to be hospitalized in the years following their augmentation surgery, than women who did not have breast augmentation.

Of course, many things in life have risks, and only you can decide what risks you are willing to take. Some women are happy with their implants, but we know many who wish they had never made that choice.

We hope this information has been helpful.

The comments and statements of the National Research Center for Women & Families are believed and intended to be accurate, and where applicable, based on scientific literature. NRC’s statements do not constitute medical diagnoses, medical advice, plans of treatment, or legal opinion, and we are not responsible for the use or application of this information. All medical information should be reviewed with your health care practitioner.

We hope that the information we’ve provided is helpful. In order to maintain this free service to all women and their families, we invite your tax-deductible contributions to NRC (see http://www.center4research.org/contribute1.html)

My silicone gel breast implant may be leaking. How do I find out if it is leaking, and what should I do if it is?

Q. My silicone gel breast implant may be leaking. How do I find out if it is leaking, and what should I do if it is?

A. We’re not doctors and we don’t provide medical advice, but I can tell you what we know based on research and from speaking with many experts and with women who have had breast implants.

The best way to tell if a silicone breast implant has ruptured or is leaking is to have an MRI with a breast coil. Unfortunately MRIs are expensive, but necessary because a mammogram can not accurately detect a rupture or leak. And, the squeezing from a mammogram can cause a broken implant to leak. A sonogram can be useful but only if the radiologist is specially trained to detect implant ruptures and leaks — and very few are. That’s why an MRI is the best strategy, although that also needs to be read by someone who has experience looking for a rupture or leak in a silicone breast implant.

FDA scientists found that by the time women have implants for at least 10 years, at least one of them has usually ruptured. However, implants often break sooner, sometimes even within the first year. For women with saline breast implants, a broken implant is obvious because it usually deflates quickly. However, when silicone gel breast implants break, there are often no symptoms at all for a year or more. Years later, there are several symptoms that many women report: the breast changes shape or gets smaller, lumps or bumps may appear on the breast or nearby, some women complain of a burning pain, and some women experience symptoms of autoimmune disease, such as joint pain, memory loss, confusion, or chronic fatigue.

Many plastic surgeons believe that silicone is “perfectly safe.” However, experts who have read the research agree that a ruptured silicone gel breast implant should be removed as soon as possible, especially if it is leaking. The MRI can help the plastic surgeon know where the problem areas are so he or she can avoid leakage during removal. Removing broken implants soon means there is less chance that the silicone will leak outside the scar tissue that surrounds the implant. It is important to have the procedure performed by a plastic surgeon who is very experienced in removing leaking silicone implants. Old or broken silicone gel breast implants should be removed “en bloc.” This means that the entire implant and the entire scar tissue capsule surrounding it are all removed together. This makes it easier to remove any silicone that may have leaked from the broken gel implant and also helps remove silicone or other chemicals that may have seeped out from the silicone envelope into the scar capsule.

A study conducted by Dr Noreen Aziz from the National Cancer Institute and Dr Frank Vasey from University of South Florida found that most women who had rheumatological symptoms (such as joint pain) felt significantly better after getting their breast implants removed and not replaced. Those who didn’t get their implants removed usually got worse. Those who had them removed and replaced (with silicone implants or saline) implants did not get better.

For examples of women who had less pain and other symptoms after their implants were removed, see the personal stories on our website at http://www.breastimplantinfo.org/personal-stories/. You also might want to check out www.explantation.com to hear from women who have had their implants removed and not replaced. Many felt healthier, happier, and more attractive afterwards.

We hope this information is helpful. Check our website for more information, or feel free to write to us.

The comments and statements of the National Research Center for Women & Families are believed and intended to be accurate, and where applicable, based on scientific literature. NRC’s statements do not constitute medical diagnoses, medical advice, plans of treatment, or legal opinion, and we are not responsible for the use or application of this information. All medical information should be reviewed with your health care practitioner.

We hope that the information we’ve provided is helpful. In order to maintain this free service to all women and their families, we invite your tax-deductible contributions to NRC (see http://www.center4research.org/contribute.html)

My saline breast implant deflated. What should I do?

Q. My saline breast implant deflated. What should I do?

A. We’re not doctors and we don’t provide medical advice, but I can tell you what we know based on research and from speaking with many experts and with women who have had breast implants.

Once a saline breast implant has deflated, it can not be refilled. If your implants have not caused any health problems before they deflate, ruptured saline implants are relatively safe if there is no mold, bacteria, or fungus. If any of these are present, you will probably notice symptoms of infection or allergic-type symptoms.

If your implants are more than a few years old, it makes sense to remove both implants at the same time, even if only one of them has ruptured. The cost of implant removal, with or without replacement, is very similar whether it involves one implant or two. As implants get older it becomes more and more likely that they will rupture. Rather than have two surgeries, it makes sense to remove (and if you want to replace) both implants together.

Many plastic surgeons are reluctant to remove an implant without replacing it because they are concerned that the patient will be very unhappy with their appearance after the implant is removed. The breast tissue stretches from the implant, and if the surgeon is not skilled in explantation without replacement, the breast is unlikely to be as attractive as it was before the implant surgery. However, after implants are removed by an experienced explant surgeon, many women are very pleased with the way their breasts look and feel. You can read some of their stories on the www.explantation.com website.

Whether or not you decide to replace your implants, you need a plastic surgeon that you are confident will do a great job. Removal can be much more complicated and expensive than the original surgery. Some plastic surgeons are very experienced at removal and are especially skilled at getting the best possible cosmetic result. The surgeon you choose should be board certified and should be willing to show you pictures of many patients’ post-explantation results, or better still, offer to have former patients talk to you. Find out if they were happy with their doctor and with their results.

The comments and statements of the National Research Center for Women & Families are believed and intended to be accurate, and where applicable, based on scientific literature. NRC’s statements do not constitute medical diagnoses, medical advice, plans of treatment, or legal opinion, and we are not responsible for the use or application of this information. All medical information should be reviewed with your health care practitioner.

We hope that the information we’ve provided is helpful. In order to maintain this free service to all women and their families, we invite your tax-deductible contributions to NRC (see http://www.center4research.org/contribute.html)

I am wondering if some of my health problems are caused by my breast implants.

Are Your Breast Implants Making You Sick- (2)

Q. I am wondering if some of my health problems are caused by my breast implants.

A. We’re not doctors and we don’t provide medical advice, but I can tell you what we know based on research and from speaking with many experts and with women who have had breast implants.

In testimony before the FDA, women with implants have described symptoms such as joint pain, chronic fatigue, mental confusion, hair loss, and flu-like symptoms. These are considered to be auto-immune symptoms, and according to the FDA, some of these symptoms are more common for women two years after getting silicone gel breast implants than they are before the women got breast implants. Those findings are based on the FDA’s analysis of women with silicone gel breast implants, and were made public on April 12-13, 2005 at a public meeting of the FDA advisory panel on breast implants.

All breast implants, even saline implants, are enveloped in an outer shell made of silicone. The envelope also contains other chemicals and some heavy metals, such as microscopic amounts of platinum or tin, which vary during the manufacturing process. Unfortunately, some women have a negative reaction to those substances. Although silicone is considered “biocompatible” and most people don’t have an allergic or autoimmune response, some people do. (Just as some people have an allergic response to peanuts or bee stings).

Any woman could potentially have a bad reaction to silicone or other substances in breast implants. However, the risks are higher for some women than others. Implant makers warn women with certain medical histories in their family or who have specific medical conditions that breast implants could be especially risky for them. Women who have family members with autoimmune diseases such as arthritis, MS, or lupus are one of the examples. Here is their exact language, located on the FDA website: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm063743.htm.

In a study of women who had breast implants for at least 7 years, FDA scientists found that women with leaking silicone gel breast implants were more likely to have fibromyalgia and other painful diseases than women with implants that were not leaking. Symptoms of fibromyalgia include pain and chronic fatigue. The FDA study was the first and most well-designed study evaluating the health effects of leaking silicone breast implants. Unfortunately, not all plastic surgeons are aware of the study, which is described in more detail on our website http://www.breastimplantinfo.org/what-you-need-to-know/ and the FDA website http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/GeneralandPlasticSurgeryDevicesPanel/UCM269672.pdf.

The good news is that research shows that many women with breast implants and rheumatologic pain and symptoms find that their health improves dramatically after their implants are removed and not replaced. Dr. Frank Vasey from the University of South Florida and Dr. Noreen Aziz, a scientist at National Cancer Institute, found that most women with pain, fatigue, and other rheumatology symptoms felt better after their silicone implants were removed and not replaced. Many symptoms lessened or disappeared over the next few months. In contrast, most women who did not have their implants removed became even more ill. Those who had their implants removed and replaced with saline usually did not get better either.

You might have read about Kacey Long, who was featured in Parade Magazine, People, and on MTV’s I Want a Famous Face. Kacey was 19 when she got saline breast implants and 21 when she had them removed. She got sick very quickly, but didn’t realize her health problems were related to her implants. She started spending all her time in bed, and was in too much pain to even comb her hair. However, when her implants were removed she immediately started to feel better.

For examples of women who had similar symptoms and felt better after their implants were removed, see the personal stories on our website at http://www.breastimplantinfo.org/personal-stories/.

If the symptoms the other women describe sound like you, you may want to consider having your implants removed. If you have silicone gel breast implants that are broken, it is important to have them removed as soon as possible. For more information about that, read the other FAQs.

The comments and statements of the National Research Center for Women & Families are believed and intended to be accurate, and where applicable, based on scientific literature. NRC’s statements do not constitute medical diagnoses, medical advice, plans of treatment, or legal opinion, and we are not responsible for the use or application of this information. All medical information should be reviewed with your health care practitioner.

We hope that the information we’ve provided is helpful. In order to maintain this free service to all women and their families, we invite your tax-deductible contributions to NRC (see http://www.center4research.org/contribute.html)

Should I get silicone or saline implants? Is there a price difference?

Q. Should I get silicone or saline implants? Is there a price difference?

A. We believe that saline breast implants are safer than silicone gel implants.

All breast implants have risks. The most common is when the breast gets hard and painful, known as capsular contracture. Many women with implants have that problem after a few years, but it appears to be more common with silicone gel breast implants than saline implants.

Implant surgery usually costs between $5,000-8,000, including the implants and one follow-up visit. Silicone gel breast implants cost about $1,000 more than saline implants.

However, there are a lot of extra expenses that you need to be aware of.

For example, saline implants and silicone implants both have a high complication rate, and almost half the women will need additional surgery to fix implant problems within 3-4 years. Some problems are cosmetic (if the breasts look phony) and some problems are more serious (such as infections, allergic reactions, or auto-immune reactions). That additional surgery often costs $5,000 or more. That is why we suggest that women considering breast implants make sure they have at least $5,000 in their savings that they will save and not spend until they need it for their next implant surgery.

All breast implants will eventually break, but when saline implants break it is obvious (they deflate quickly) and when silicone gel breast implants break, there are often no symptoms at first. Having no symptoms might seem like an advantage, but it is really a disadvantage because silicone can leak out of the tear in the implant, and get to parts of the body where surgeons can’t remove it. Leaking silicone can cause pain and allergic or auto-immune reactions. When it is removed, the breast may be deformed.

Because of concerns about leaking silicone, the FDA warns that women with silicone gel breast implants need to get an MRI to check for leakage after 3 years, and then every other year after that. Unfortunately, breast MRIs cost about $2,000 each, sometimes more. That may seem very expensive, but it is the only accurate way to know if your implants are broken or leaking. If they are leaking, it is important to have them removed immediately.

Given the expense and the risks, why would any woman get silicone gel breast implants? There is one advantage: they feel more like a real breast. Saline implants may not feel as warm as the rest of the body in cold weather. (A figure skater told us they were painfully cold!) And, women with saline implants sometimes say that they make swooshing water noises. Most plastic surgeons prefer silicone gel implants because they tend to look and feel more natural. However, many women tell us that does not make up for the added risks and added costs.

But, it is important to know that all breast implants – saline or silicone – can cause serious health problems. They can even cause a type of cancer of the immune system, known as anaplastic large cell lymphoma (ALCL).

The bottom line: all breast implants will break, all breast implants are likely to cause complications that require additional surgery, and some women will have a bad reaction within a few weeks or months of getting their breast implants. Some complications are very serious. But some breast implants are safer than others, and since all silicone gel breast implants are more likely to leak as they get older, we believe that saline implants are safer.

Photos of what happens when removing silicone
deforms the breast. Click for larger view.

The comments and statements of the National Center for Health Research are believed and intended to be accurate, and where applicable, based on scientific literature. NCHR’s statements do not constitute medical diagnoses, medical advice, plans of treatment, or legal opinion, and we are not responsible for the use or application of this information. All medical information should be reviewed with your health care practitioner.

We hope that the information we’ve provided is helpful. In order to maintain this free service, we invite your tax-deductible contributions to NCHR (see http://www.center4research.org/contribute.html)