PIP breast implants: review to give findings

Plastic surgeon Professor Laurence Kirwan: "I think this is a serious health issue"

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Some 40,000 British women with banned PIP breast implants are expected to learn later whether the government believes they should be removed.

France banned the implants, by the French firm Poly Implant Prothese, in 2010 and said they needed to be taken out due to a high risk of leaking.

They were found to have industrial, rather than medical grade silicone gel.

The UK government has so far said the risk is low but ordered a review because of conflicting data.

The findings of the review into the rupture risk will be released soon.

What rate?

The key question will be the rupture rate of the implants. The French authorities have quoted a rate of 5%. The UK's Medicines and Healthcare products Regulatory Agency (MHRA) said the rate was 1% - in line with other implants.

The health secretary, Andrew Lansley, ordered the review amid reports of rupture rates of 7% from one cosmetic surgery group, Transform. However, it says that rate was based on just seven out of 108 patients it fitted with PIP implants since 2005.

What are the risks?

  • The silicone inside the implants is not medical grade - but was intended for use in mattresses
  • Tests have not shown any increased risk of toxicity from this filler compared with normal implants
  • But mechanical testing has shown the implant covers have an increased risk of rupturing
  • The gel inside can be irritative, increasing the risk of inflammation reaction - making removal more difficult
  • There is no increased breast cancer risk
  • One case of a rare form of cancer called anaplastic large cell lymphoma (ALCL) was recently reported in France
  • French and US experts suggest there is a small but increased risk of this cancer in women with breast implants in general

The organisation which represents the majority of UK private breast implant clinics has insisted the rupture rate is not abnormally high.

Sally Taber, director of the Independent Healthcare Advisory Services, said: "Following an audit of our members, which includes data on thousands of patients... we can confirm that the average rupture rates reported for PIP implants are within the industry standard of 1-2%."

On Tuesday, Mr Lansley said the data from private companies had been "inconsistent" and was sometimes "inadequate" and of "poor quality".

Prof Sir Bruce Keogh, the NHS medical director who is leading the review, said: "I am disappointed at the ability of some private providers to submit accurate and meaningful data. I am pursuing this with vigour."

They were set a deadline of Thursday to provide the information or they would be named and shamed.

The advice from government officials has consistently been against removing the implants.

The chief medical officer for England, Prof Dame Sally Davies, initially said: "We currently have no evidence to make us think they should have the PIP breast implants removed."

Then, three days before the review was due to report, Mr Lansley told the BBC: "The overwhelming evidence continues to support the advice we've given women previously.

"It is not advisable for women to routinely have implants removed because the risk associated with an operation of that kind would outweigh the benefit of removing these implants."

The president of the British Association Aesthetic Plastic Surgeons, Fazel Fatah, has argued that all implants should be removed.

He said it would be impossible to find out the exact rupture rates and that the important issue was the quality of the silicone as "it is not fit to be implanted into humans".

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