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Shari Graydon

Breast implants are still a gamble Add to ...

The character Cameron Diaz plays in Bad Teacher so embodies the film's title that viewers might conclude she deserves those breast implants she's so intent on having. But I wouldn't wish them on my worst enemy, and the U.S. Food and Drug Administration's latest review of data about their long-term health implications hasn't changed my mind.

Since 2006, when silicone implants were reintroduced in Canada, their manufacturers have been required to conduct more research on how their devices fare in women's bodies over the long haul. Although the studies aren't complete, they've lost track of significant numbers of patients. One of the larger ones - designed to follow health complications in 40,000 women - is now monitoring less than a third of those initially registered.

Still, the FDA deems the implants to be "relatively safe," even as its updated research confirms what women's health advocates have been saying for years: "The longer a woman has silicone gel-filled breast implants, the more likely she is to experience local complications or adverse outcomes." Indeed, as many as one out of five cosmetic patients and one out of two reconstruction patients need to have their implants removed within 10 years of their first implantation.

These are pretty bad odds when you consider the health and financial costs involved. The phrase "local complications or adverse outcomes" conceals a litany of risks, including infection, bleeding, breakage, leakage, necrosis (skin death), and hardening of scar tissue or the implant itself - any of which can cause serious discomfort and the need for immediate surgery.

According to Canadian research, implanted women visit their doctors and are hospitalized exponentially more often than other women of the same age. Some develop chronic flu symptoms that plague them for years. Others become so ill they can't work. That's why most health insurers are reluctant to insure women with breast implants - even after they've had them removed. Nor do they pay removal costs, even if the implants are leaking or deflated.

A woman getting implants for augmentation typically pays as much as $5,000. But the replacement or removal operations cost as much as $15,000. Add in the MRI tests to determine whether silicone implants are leaking (another $2,000 to $3,000), and you're looking at a lifetime investment of hundreds of thousands of dollars - not counting lost wages because of time off for the surgery and related health complications.

One Canadian study found that the incidence of subsequent surgery was so significant that 40 per cent of the women had their implants permanently removed to avoid future problems.

This points to another concern: Augmentation patients unhappy with their breasts before implants are likely to hate them once the devices are removed, when the remaining skin is often saggy and stretched out. Knowing this, many surgeons refuse to remove the implants unless they're replaced.

Like many women my age, I have friends who've lost breasts to cancer. Reviewing the available evidence about implants while battling a potentially fatal disease, none was willing to play breast roulette and get implants, despite their appearance concerns. Given what's known (but not always readily shared) about the continuing cycle of complications and repeat surgeries, it makes even less sense for healthy women to gamble on implants.

Author Shari Graydon sits on the advisory board of the B.C. Centre of Excellence for Women's Health.

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