Two main types of synthetic breast implants are available in the UK: saline and silicone gel.
Both have a silicone outer shell but the inside is different. Saline implants are filled with saline or sterile saltwater. Silicone breast implants are filled with silicone gel.
Breast augmentation is the most common cosmetic procedure in the UK and in most cases there are no complications. However, all surgical procedures carry some risks. With breast implants, these include rupture or surgery errors.
The safety and risks of breast implants was brought into focus in 2011 by the problems with French made PIP implants received by around 40,000 women in the UK. These implants contained non-medical grade silicone gel and are more likely to rupture.
An expert review in the UK had found no evidence of a link with cancer, or that dangerous toxins could leak into the body.
A European Commission report also found that women with PIP implants are not at higher risk of cancer.
The situation for women in the UK with PIP implants varied for women depending on whether the implants were done privately or on the NHS, and which part of the UK they live in.
The NHS offered to pay for women fitted with the implants by the NHS to have them removed. Some private clinics offered to rectify the problem implants, while others didn't. Women with concerns were told their GP could arrange for diagnostic scans.
A review into cosmetic surgery and procedures ordered after the PIP scandal concluded that people should be better protected.
Among the main recommendations were:
All cosmetic implants, including dermal fillers, should be made to conform with the EU's Medical Devices Directive
A law should be passed to classify fillers as a prescription-only medical device
A group should be set up under the direction of The Royal College of Surgeons to set standards for cosmetic surgery practice and training
Set up a compulsory register for those performing cosmetic interventions
Establish a breast implant register so that patients can be monitored
Ensure that practitioners are insured in the event of treatment going wrong
Make it compulsory for practitioners to ensure that patients understand the risks and benefits of treatment before they give consent
Establish a code of conduct for advertising.
Breast implant risks
There are no significant differences in the safety of silicone and saline implants. However, each type of breast implant has its pros and cons and these should be discussed with the cosmetic surgeon before going ahead with the procedure:
Ruptures. Ruptures are a risk with both kinds of breast implant. Ruptures might be caused by surgical error, a fall, or very occasionally by the pressure exerted on the breast during a mammogram. The implications of a rupture are a little different for the two types of breast implant.
Saline implant ruptures are easy to spot. The breast rapidly changes shape over days as the fluid leaks out. If a saline implant breaks, all that leaks out is saltwater. The saltwater is harmlessly absorbed into the body.
Silicone implant ruptures are more difficult to spot. When the implant breaks, the leaking silicone stays in the body.
Ruptures of silicone breast implants are often “silent” and patients and doctors may not notice them. They can only be detected by an MRI scan.
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