BAAPS supported the finding of the expert group, who reviewed the risks posed by PIP silicone breast implants, and welcomed the subsequent advice from the Department of Health (DoH). BAAPS were represented on the expert group by the former President, Mr Fazel Fatah in 2013.
Current advice for patients
All patients were advised that they should be aware of the make of their implants. Those patients unsure of these details were advised to contact their surgeon/ provider. Patients were advised that BAAPS agreed with the DoH expectation that patients should not be charged to access their notes. All NHS patients who had a PIP implant should have been contacted by their hospital.
The only patients who needed to be concerned were patients who have PIP implants.
BAAPS agreed with the following findings of the expert group in 2013:
a. There was no evidence that PIP implants were responsible for an increased rate of breast cancer.
b. The evidence provided to the group to enable assessment of rupture rates was incomplete, further data was being sought.
c. There was anecdotal evidence that the gel component of the implants was less cohesive (sticky) than most other contemporary implants.
d. There was some anecdotal evidence, supported by animal studies, that the gel had a greater potential to cause local inflammation in the tissues.
e. The implication of these last two findings was that the gel had a greater opportunity to interface with the breast tissue in the case of rupture and leak, and that if it did, it had a greater potential to cause irritation and inflammatory reaction within the local tissue.
Signs and Symptoms of Rupture/Leak/Inflammation in one or both breasts
Signs may include:
Lumpiness of the breast
Lumpiness/ swelling of the regional lymph nodes in the underarms and rarely in the neck
Change in shape and size of the breast
Redness of the skin
Tenderness of the breast and or the lymph glands in the underarms
Swelling of the breast
Firmness of the breast
Symptoms may include:
The advice to patients was that those who experienced signs or symptoms of rupture or irritation should seek advice from their surgeon.
Those who do not have complaints but have concerns and wish to discuss the risks and benefits of implant exchange should also seek advice from their surgeon at some stage.
Who should you go to for advice?
Patients who had their breasts reconstructed on the NHS or had private breast augmentation with surgeons or clinics who are no longer in business will be able to be seen in an NHS clinic either following referral by their GP, or following direct invitation from their hospital department.
For patients (NHS and private) with lumps in the breast or regional lymphatic tissue
In cases where there was concern regarding the nature of the lumpiness referral should have been made to a rapid access breast service.
In cases where the practitioner was confident that the lumps were associated with the implant or gel, referral should have been made to the regional plastic and reconstructive breast surgery department. These patients would not have required fast track referral.
For patients who had their breast augmentation with PIP implants in the private sector and had no symptoms
The government and all the surgical associations expected the private providers who used PIP implants to take the responsibility of duty of care towards their patients seriously and treat them with dignity and compassion.
Fazel Fatah, the former President of the British Association of Aesthetic Plastic Surgeons felt that the long held view of our Association, that it was advisable to remove or replace these implants in view of the inferior quality of the gel used in the manufacturing of the PIP implants, was vindicated, regardless of the rupture rate. Removal was advised as a precaution to prevent inflammation of the breast and the lymph glands in cases of rupture.
'We are also delighted that the Government now acknowledge the need for regulation of the cosmetic surgery sector and the establishment of a national breast implant register, two important developments that we have been campaigning for tirelessly for some time. Patient safety is the guiding principle of our Association.'
BAAPS felt that the current advice to patients took into account both the available scientific data and the understandable anxieties of patients. Many BAAPS surgeons had already been asked to give advice to patients who had their PIP implants inserted elsewhere, our members continued to provide the most up to date advice, care and compassion.
Please click here for a link to the Joint Surgical Statement on Clinical Guidance for Patients and Doctors issued by the Royal College of Surgeons of England