Fuel Additives and Industrial Silicone

What are fuel additives doing in breast implants?

That’s the question asked by French national radio station RTL after a prominent toxicologist declared he discovered baysilone – sometimes used as fuel additive and lubricating grease –  silopren and rhodorsil in the frequently rupturing 300,000 silicone implants made by Poly Implant Prothese. PIP used to be the third largest breast implant maker in the world. Bankrupt in 2010, its leaders should face multiple criminal charges.  Its president, Clement Mas, has admitted using “non-surgical” silicone within the implants.

The French government has requested all 30,000 Frenchwomen with the PIP implants have them surgically removed.

The British government originally said no. However, the health minister has backtracked, allowing the National Health Service to take out – for free – all implants they put in, as well as those private surgeons refuse to remove – provoking a minor war with several private clinic and hospitals.   The Czech Republic and the German government are requesting removal of all of the implants, which were not used in the US.

Should American women worry about their breast implants?

Reasons People Get Implants

Many women say they really like their implants – and breast implants are presently the most popular plastic surgery done in the US (some are done for breast reconstruction following breast cancer.)  When asked why they have them women’s reasons include:

1. Self confidence

2. Looking better

3. Guys like them

4. Improved self esteem

5. More attention

Types of Implants

Breast implant impacts are clouded by the several different kinds available – though not all are presently available in the US:

Silicone

Saline

Double lumen

Polyurethane

Cohesive silicone

Americans generally get saline or silicone implants; polyurethane may make a comeback.

Problems with Implants

Plastic surgeons are usually careful explaining to people what complications can ensue from breast implants.  They include

1. Infection

2. Breast pain

3. Changes in breast sensitivity

4. Capsular rupture

5. Scarring

6. Need for repeated MRIs to check the breast every two years

7. Inability to breast feed

8. Inaccuracy of mammograms after augmentation

9. Need to replace the implant; some argue most implants won’t last past 10-15 years.

Issues of polyurethane implants causing breast cancer remain highly controversial; many researchers don’t think they do.  Others argue that capsular breakage of silicone leads to autoimmune disorders that are hard to treat; the prevalence of this problem remains difficult to accurately estimate.

Chemicals and Complexity

People will do a lot for beauty.  Most women who get breast augmentation pay out of pocket for the entire procedure. They may also pay out of pocket for any required revisions following the procedure – and for many of the potential problems that arise.

Do people really understand the long term health implications of implants?  The literature is sparse.  Neither the advantages – in self esteem, confidence, and pleasure in life – nor the disadvantages – fear of rupture, cancer, changes in pain and sensitivity – have been carefully looked in long term clinical trials.

It’s time for government agencies – like Britain’s Nice Insitute on Clinical Effectiveness – to do just that.

Long term trials are also needed on many devices.  The current disaster in hip replacements – with metal on metal hips failing early  – shows the need for clinical trials before major devices are deemed safe.

Fortunately data analysis is presently becoming more sophisticated.   And with the net, accessing clinical data – especially in countries with national health systems that keep it – should make retrospective studies easier.

Yet prospective studies are needed more than ever.

The Black Box

Medical devices have long received a pass from many national health authorities, including the FDA.  Ask the drug companies.  It’s vastly harder getting a new drug to market compared to a medical device – or an herbal drug.

The public health deserves better. And it’s not just medical drugs and devices where regulation can be much improved.  According to the magazine the Week, 80,000 chemicals have been added to the environment since World War II.

Only 200 have been actively studied.

We don’t want industrial solvents in breast implants.

What you don’t know can hurt you.
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