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How risky are breast
implants? This is a controversial question, but implant manufacturers
have done research showing that local complications, including pain,
rupture, and the need for additional surgery, are very common within
the first three years.
The FDA required breast
implant manufacturers Mentor Corporation and Inamed Aesthetics (formerly
called McGhan) to conduct research on the complications of saline
breast implants for breast reconstruction and breast augmentation
patients. The purpose of this research was to provide women with
information so that they can make a more informed decision about
whether or not they want saline breast implants. This information
is supposed to be made available by plastic surgeons to all patients
before they make their decision. The studies did not include diseases
or conditions such as cancer, lupus, or fibromyalgia.
This CPR issue brief
is based on the FDA's analyses of data collected by Mentor Corporation
and Inamed Aesthetics. It is based on research, not opinion. The
3-year data were analyzed by the FDA in 2000 and the 5-year data
were analyzed in 2002. This fact sheet is only about reconstruction
patients.
Mentor
Saline Implants
Mentor conducted a 5-year study on reconstruction
patients. Unfortunately, so many women (almost 60%) dropped out
of the study before the five years were completed, that the information
is not reliable. For that reason, we are only providing the information
collected during the first 3 years after getting implants, which
included 78% of the patients.
Important
Points from the Mentor Data
-
Most women can expect at least one complication within the first
3 years.
-
40% of reconstruction patients can expect to have additional surgery
within the first 3 years.
Mentor Reconstruction Patients 3-Year Complication Rate
Reconstruction
patients experienced the following problems within the first 3 years
of receiving their implants:
| 40% |
Needed
another operation |
| 30% |
Capsular
contracture (hardening of breast) |
| 28% |
Asymmetry
(breasts look different from each other) |
| 27% |
Implant
removal |
| 20% |
Wrinkled
appearance of breast |
| 17% |
Breast
pain |
| 9% |
Infection |
| 9% |
Implant
leaks/deflates |
| 8% |
Irritation/inflammation |
| 6% |
Delayed
wound healing |
| 6% |
Seroma
(watery portion of blood collects around implant or incision)
|
| 5% |
Scarring
complications |
| 2% |
Extrusion
(implant comes through the skin) |
| 2% |
Necrosis
(death of skin or tissue) |
| 1% |
Hematoma
(blood collects around implant) |
| 1% |
Position
of implant changes |
Loss of nipple sensation is not listed since nipples are removed
during mastectomy. |
| Only
78% of the reconstruction patients who originally enrolled in
the study completed all 3 years. Women who had their implants
removed, and women who left the study for any reason were not
followed. Complications were measured up until a woman left
the study, but percentages were based on the total number of
women who started the study. So, the complication rate is actually
even higher. |
Inamed
Saline Implants
Inamed, formerly called McGhan, conducted a 5-year study on breast reconstruction patients.
They collected information at the 3-year point from 71% of the reconstruction patients who
originally enrolled in the study.
At the 5-year point they collected information from 57% of the reconstruction patients. This is a problem, since no information is available for 43% of the patients. Women who had their implants removed, and women who left the study for any reason were not followed. Complications were measured up until a woman left the study, but percentages were based on the total number of women who started the study. So, the complication rate is actually even higher, and the 3-year data are more reliable than the 5-year data.
Important
Points from the Inamed Data
-
Most women can expect to experience at least one complication
at some point within 5 years after implant surgery.
-
40% of reconstruction patients can expect to have additional surgery
within the first 5 years.
Inamed Reconstruction Patients 3-Year and 5-Year Complication Rates
Reconstruction patients experienced the following complications during the first three years and first five years after surgery.
| 3-Year |
5-Year |
|
| 39% |
45% |
Needed
another operation |
| 33% |
39% |
Asymmetry (breasts look different from each other) |
| 25% |
36% |
Capsular contracture (hardening of breast) |
| 23% |
28% |
Implant replacement/removal - any reason |
| 20% |
27% |
Implant
can be felt or seen |
| 23% |
25% |
Wrinkled appearance of breast |
| 15% |
18% |
Breast pain |
| 12% |
17% |
Implant is in a bad position |
| 6% |
8% |
Implants leaks/deflates |
| 7% |
7% |
Irritation/inflammation |
| 6% |
6% |
Intense
skin sensation |
| 6% |
6% |
Scarring
complications |
| 5% |
6% |
Infection |
| 5% |
5% |
Calcium deposits form around implant |
| 4% |
4% |
Seroma
(watery portion of blood collects around implant or incision) |
| 4% |
4% |
Skin/tissue
necrosis (death of skin or tissue) |
| 3% |
3% |
Delayed
wound healing |
| 3% |
3% |
Implant
extrusion (implant comes through the skin) |
| 3% |
3% |
Skin Rash |
| 1% |
1% |
Hematoma
(blood collects around the implant) |
Loss of nipple sensation is not listed since nipples
are removed during mastectomy.
| Most
complications for Inamed patients through the first 5 years
are similar to those reported after the first 3 years. Since
it is well known that some complications, such as rupture and
capsular contracture, increase over time, women with complications
were apparently more likely to leave the study than those who
continued. Some of these women have left their plastic surgeons
and could not be contacted. |
For information on augmentation complication rates, click
here
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