11 January 2012 Last updated at 06:37 ET

Q&A: PIP breast implants health scare

By James Gallagher Health reporter, BBC News

French breast implants have caused a health scare in Europe and South America due to a high risk of rupturing in the body.

The response has varied, notably between the UK and France.

French authorities have reported a high rupture rate and are offering to remove all implants.

UK figures report a lower rupture rate. For now the government says there is no need for routine implant removal, but it is conducting a review.

What is the problem?

The issue is with silicone breast implants made by the French company Poly Implant Prothese (PIP).

The firm's products were banned in 2010 when it emerged that industrial grade silicone was being used. Implants should be made from medical grade material, which has passed safety tests for use in a human body.

No increased risk of toxicity has been reported, but the implants are at greater risk of rupturing.

What happens when a silicone implant ruptures?

When an implant ruptures, the silicone gel filling can leak into the body. Some women will not notice anything at all and there is no evidence of an increased cancer risk.

However, it can result in the formation of scar tissue which can change the shape and feel of the breast. The gel can be an irritant, causing pain and inflammation. It can also be more difficult to remove an implant once it has ruptured.

The French authorities have highlighted an unknown potential risk from the untested silicone gel.

How many women are affected?

Globally, more than 300,000 implants have been sold in 65 countries in the last 12 years. Europe was a major market, but more than half of the implants went to South America.

It is thought that about 40,000 British women have the implants. Private clinics fitted 95% of the implants, mostly for breast augmentation. Five per cent were performed by the NHS.

But how many implants have actually ruptured?

There are various figures depending on which organisation or country is reporting them. The French authorities say the rupture rate is 5%.

The UK's Medicines and Healthcare products Regulatory Agency (MHRA) has a figure of 1% and said that after speaking to other countries, there was "no evidence of any disproportionate rupture rates other than in France".

A major UK private clinic, Transform, was reported as saying it had a rupture rate of 7%. It says this was based on a sample of 108 patients.

The organisation which represents private breast implant clinics, The Independent Healthcare Advisory Services, says that after looking at data from thousands of patients the rupture rate was within the industry standard of 1-2%.

Should the implants be removed?

In France the answer is yes. Authorities say the implants should be removed as a precaution. Venezuela, Germany and the Czech Republic have taken the same stance.

In the UK, a review, led by NHS Medical Director Prof Bruce Keogh, concluded that: "On the basis of the information we have, we do not think it is necessary to recommend the routine removal of these implants."

However, it highlighted that anxiety about the implants was itself a health concern and women should be able to have them removed if they wanted to.

The president of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), Tim Goodacre, said: "Given the fact there is a degree of uncertainty and a lack of knowledge, we're recommending all implants come out."

Who will pay?

The French government has offered to foot the bill for the 30,000 French women affected to have their implants removed.

The Venezuelan health minister Eugenia Sader said the government would cover the costs of removing the implants, but would not pay for replacements.

In the UK, the NHS will remove and replace the implants from women operated on by the health service. The health secretary Andrew Lansley said private clinics had a moral obligation to do the same.

The NHS will pay to remove, but not replace, implants fitted privately if the clinics refuse the patient or have gone out of business.

Meanwhile, the Welsh government said it would pay to remove and replace privately fitted implants.

Where should women go for advice?

For now, women are being advised to speak to the surgeon who operated on them.