Date: Thu, 10 Aug 2000 00:41:41 -0700

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Hidden Dangers of Implants

A Plastic Surgeon Details Problems Women May Not Be Aware Of

March 10, 2000

Beth Gilbert drkoop.com Health News

Dallas plastic surgeon Dr. H.S. Byrd figures he does at least one or two corrective surgical procedures every week on women whose breast implants have gone wrong.

"The truth is, I'd like to be put out of business," Byrd said. Byrd, who is chief of plastic surgery at Baylor University, president of the Dallas County Cosmetic Surgery Society and a professor at the University of Texas Southwestern Medical Center, said, "Not every implant problem I fix is another surgeon's error -- some problems are with the implant itself.

"But I think it's become harder than ever before for a woman to figure out who out there is a good and qualified doctor to perform her surgery and to fix problems that arise," Byrd said. "There are just too many doctors not qualified to do plastic surgery -- who don't have the experience or the training -- who are doing it. And the patient doesn't realize it."

The most common problem, Byrd said, is capsular contracture. This occurs if the internal scar or pocket around the implant tightens. It can make the breast feel hard. "In some cases, this capsular contracture is completely painless to the patient," Byrd said. "But in others, the implant shifts position, which causes the breast to look distorted -- and which can be quite painful."

Generally, the capsular contracture is fixed by cutting or removing the scar tissue and removing or replacing the implant. But there's no guarantee it won't happen again. "I find this problem occurs much less frequently when we use saline implants placed under the pectoral muscle," Byrd said.

Another problem sometimes occurs when a saline implant is placed on top of the pectoral muscle in a thin woman. With little internal support, the saline shifts to the bottom of the implant and imparts a wrinkly or rippled appearance to the skin of the upper breast. Substituting a fuller saline implant and placing it under the pectoral muscle fixes this problem.

Sometimes implants deflate and need to be removed and replaced. "Implants are supposed to withstand normal wear and tear -- even the squeezing during a mammogram," Byrd said. "But sometimes they don't. I've seen an implant deflate from the sudden hard pressure of a shoulder harness during a car accident."

Even if the surgery and recovery go smoothly, there's no absolute guarantee that there won't be complications later on. "The bottom line is find a qualified plastic surgeon with expertise in both silicone and saline implants. That heritage of knowledge is invaluable," Byrd said. "And make sure you, the consumer, are well educated about these elective cosmetic surgeries so you can make informed decisions."

Beth Gilbert is a drkoop.com contributor based in New York City.