Over the past decade the procedure has been perfected to a fine art to be aesthetically pleasing.

What is a Breast Implant

A breast implant consists of silicone elastomer casing or envelope that is usually filled with silicone gel or with a soft cohesive silicone gel that has a shape retaining memory. Implants can also be filled with a saline solution. Silicone gel and the saline (salt-water) solution are the best-known and most extensively researched fillers. In addition to these fillers, alternative fillers such as soya oil, PVP and Hydrogel have also been experimented with. Your doctor can tell you more about each filler.

Not only are there choices in fillers, but the casing that houses the implant can also vary. The surface may be rough or smooth, and interact differently with the tissue around the implant. Capsule formation is a normal body reaction which occurs around any non-bodily tissue, such as a hip prosthesis, an artificial heart valve or even a splinter in the skin. With breast implants the capsule sometimes contracts after it forms, resulting in a hard and painful breast. The rough surface feature allows some tissue adherence into the surface, which has been associated with a reduced risk of capsular contracture. A smooth-surfaced implant lacks this feature, and may be associated with a greater risk of capsular contracture.

Silicons and Safety

Silicones have been in use for over 50 years in various applications, both in everyday life and in medicine. Silicone is one of the most intensively-researched materials used in medicine and has been subjected to extensive safety testing. Silicones are also widely used in the pharmaceutical and food industries, and in many medical devices such as pacemakers, heart valves, suture materials, lubricants and coatings for hypodermic needles and syringes and blood bags. Silicones are even found in puddings, cake mixes, soft drinks, lipsticks, body lotions, suntan creams, deodorants, hairsprays, bedding, clothing, tissues and baby-care products.

Breast cancer

You do not need to fear an increase in the risk of breast cancer following breast augmentation, as there is not a shred of evidence for this. It will remain possible for you to examine your own breasts and to undergo mammography (i.e. x-ray of the breast).

Autoimmune diseases and other symptoms

At one time it was suggested that there was a link between breast implants and autoimmune diseases such as rheumatoid arthritis, scleroderma and connective tissue disorders (CTDs), as well as a variety of other symptoms such as back pain, chronic fatigue and problems with concentration. However, many major scientific studies involving thousands of women, performed at renowned research institutes, have found no scientific evidence of such a link.
Silicones and breast-feeding

No evidence has been found that silicones filter through into breast milk. It is possible for a woman to breast-feed without difficulty following breast augmentation, provided there has been no surgical damage to the milk ducts (mostly a risk associated with an areolar incision).

Recent Research on Silicon Implants

The following is recent information we aquired on silicon breast implants.

July 1998
Foreword

To the Chief Medical Officer

I am pleased to present the report of the Independent Review Group. We were charged by you with the responsibility to 'review the evidence relating to the possible health risks associated with silicone gel breast implants, to examine the issues relating to pre-operative patient information and to report to you on our conclusions'.

We are aware of the importance of the outcomes of our task for women who have had, and who will have, silicone gel breast implants, for their families, for health care professionals involved in their care, for manufactures, lawyers, and others who are concerned with the issues surrounding the use of silicone gel breast implants.

Our members were selected for their independent views, their knowledge and understanding of the issues and lack of any vested interest in the conclusions reached. We have met frequently, have considered and extensive literature, including patients, patient groups, clinicians, lawyers, manufactures and scientists. This evidence has been gathered from experts both in the United Kingdom and overseas.

We have taken a fresh look at the existing and emerging scientific evidence for a link between silicone gel breast implants and effects on health. In the process of this, we have been conscious of the need to examine carefully the causes of ill health in a number of women with implants.

We have made recommendations which will address the concerns of women with silicone gel breast implants, encourage further research into important areas, and enable clinicians, manufactures, scientists and the general public to work together to ensure the highest levels of confidence in the production, use and long term effects of silicone gel breast implants.

Professor Roger D Sturrock MD FRCP
Chairman of the Independent Review Group
The McLeod / Arthritis Research Campaign Professor
Of Rheumatology, University of Glasgow.

Overall Conclusions from the Scientific Evidence

Having reviewed all the available evidence, the IRG have reached a number of conclusion.

1. There is no histopathological or conclusive immunological evidence for an abnormal immune response to silicone from breast implants in tissue.
2. There is no epidemiological evidence for any link between silicone gel breast implants and any established connective tissue disease. If there is a risk of connective tissue disease, it is too small to be quantified. The IRG cannot justify recommending further epidemiological studies to investigate this hypothesis.
3. Good evidence for the existence of atypical connective tissue disease or undefined conditions such as 'silicone poisoning' is lacking. It is possible that other conditions such as low grade chronic infection may account for some of the non-specific illnesses noted in some women with silicone gel breast implants.
4. The overall biological response to silicone is consistent with conventional forms of response to foreign material, rather than an unusual toxic reaction.
5. There is no evidence that children of women with breast implants are at increased risk of connective tissue disease.

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