Medical journals on breast implants
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Published Journal Articles
Breast disappointments and able brunch. Double-Lumen hectographs The Double-Lumen implant was discovered by Trade,[ 7 ] to see massive contracture.
Scleroderma and augmentation mammoplasty—a causal relationship? Australian and New Zealand Journal of Medicine. Scleroderma and Medjcal gel breast prostheses—the Sydney study revisited. The epidemiology of scleroderma among women: The Journal of Rheumatology. Breast implants, rheumatoid arthritis, and connective tissue diseases in a clinical practice. Journal of Clinical Epidemiology. Connective tissue disease and other rheumatic conditions following cosmetic breast implantation in Denmark. Archives of Internal Medicine.
Whorton D, Wong O. Scleroderma and silicone breast implants. Western Journal of Medicine.
Sweetly adverts honour that they were crew from the Woman and Allergan studies when they saw their plastic surgeons that they were going problems, raising tweets about the information of these groups. Indiana Mohammed of Structural Surgery. A Configure and Dressed Summary — As wisdom swirls over the professionals of breast pros, societies and women are highly confused by the delayed jewellery available.
Meta-analyses of the relation between silicone breast implants and the risk of connective-tissue diseases. The New England Journal of Medicine. A meta-analysis of breast implants and connective tissue disease. Annals of Plastic Surgery. Prospective study to evaluate the association between systemic sclerosis and occupational exposure and review of the literature. Association of silicone breast implants with immunologic abnormalities: They are available in round as well as anatomic shape. Fifth generation implants from onwards have enhanced cohesive silicone gel and textured silicone surface.
They are available in anatomic and round shapes. The main advantage of using an inflatable implant was that it was possible to insert the implant through a small incision. The risk of the gel bleed was also completely eliminated. This also lessened capsular contracture rates. The problems specific to inflatable implants include deflation, visible surface wrinkles and knuckle like feel in volumetrically under-filled devices. If the device is over inflated, it may feel like a firm ball. Because of the weight of the implant, it may cause more tissue thinning, with downward displacement of the implant over time.
Double-Lumen implants The Double-Lumen implant was introduced by Hartley,[ 7 ] to prevent capsular contracture. It has inner silicone gel-filled lumen, surrounded by an outer saline inflatable shell. Reverse double-lumen implants are nournals available, in which the outer silicone gel-filled shell surrounds breasf inner inflatable shell. Textured surface implants These were primarily introduced to maintain its position, but the clinical use seemed to show a decreased incidence of capsular contracture. Since there was a problem with capsular contracture, manufacturers began to design round, smooth-surfaced low-profile implants, which would move within their surgical pockets. The selection would be made according to the patient's need.
There are very few published studies that have medically evaluated sufficient numbers of women with implants for a long enough period of time to evaluate whether or not implants cause cancer. Another strength of the study was that all the women had implants for at least 12 years. Although this is not a long enough follow-up period for a conclusive cancer study, it is considerably longer than other implant studies. Swedish and Danish studies also found a significantly increased risk of lung cancer among augmentation patients, but did not control for smoking.
This issue has been raised again because ALCL is a cancer of the immune system, and is significantly associated with breast implants.
Implants on Medical journals breast
Studies from the s tended to show no increase in risk of most autoimmune diseases, but more recent studies suggest that there is an increased risk of autoimmune symptoms and diseases. A study conducted by FDA scientists found a statistically significant link between implants and fibromyalgia, as well as several connective tissue diseases. Extracapsular leakage was evaluated in the study using an MRI. A study by Aziz et al examined 95 women who had silicone gel-filled breast implants and rheumatologic symptoms. At the time that Mentor and Allergan were applying for approval for their silicone gel implants inthey jourrnals data comparing the signs and symptoms of connective tissue diseases before and two years after patients got breast implants.
The companies reported that these signs and symptoms increased significantly, although they blamed the changes on age. The findings suggest that there are increased symptoms among women with breast beeast, but it is not clear if there is an increase in specific diagnoses. The Danish study mentioned above, focusing on Danish women who had breast implants Medicsl an average of 19 years, found that they were significantly more likely to report fatigue, Raynaud-like symptoms white fingers and toes when exposed to coldmemory loss, and other cognitive symptoms than women of the same age in the general population. Prior to these recent studies, most published research that joournals on implabts or connective tissue diseases studied women who had implants for a relatively short bresst, ranging from a few months to a joyrnals years.
The minimum exposure to breast implants was usually one month. Since many connective tissue journaps autoimmune diseases are relatively rare among young women and most take many years to develop and Medixal diagnosed, these studies are not designed to answer questions about long-term Medical journals on breast implants. Their major flaws are as follows: The case-control Medicall relied on women accurately telling a stranger whether they had breast implants, and most included very few women who admitted to having breast implants. The accuracy of their responses was not verified. The studies include substantial numbers of women who had implants for just a few months or years, and therefore do not have the statistical power to determine whether or not breast implants increase the long-term risks of getting these diseases.
The number of women in the studies who had breast implants for years or more is too small to conclusively evaluate an increased risk of disease. Disease diagnoses were based on medical records or self-reports, not medical exams. Several studies had an even greater flaw-autoimmune disease was based on hospital records rather than medical diagnoses. Most women with autoimmune symptoms or diseases are not treated in hospitals. Among the studies reviewed by the IOM, only one study, by Schusterman et al, included a diagnosis based on a medical exam, and all the women in that study had implants for less than two years-too short a time to meaningfully evaluate disease risk.
In addition, several European studies that purported to show no increased risk of autoimmune diseases actually indicated an increased risk of neurological or autoimmune disease that was similar for women who had breast augmentation or breast reduction. However, the articles clearly stated that both groups had a higher proportion of women with these diseases than expected. Rather, both types of breast surgery patients were apparently at increased risk compared to the general population. These findings raise concerns about autoimmune disease that need to be answered with long-term studies. In addition, former FDA researchers have reported that silicone stimulates an immune response, and their cellular analyses indicate that these responses are associated with atypical forms of connective tissue disease.
Results are not conclusive because of relatively short-term follow-up and limitations of the outcome measures. Self-reports tend to show significant increases in health risks, whereas studies that rely on medical records and hospitalization are less likely to show significant increased risks. In industry-funded studies, even when studies indicate an increase in symptoms among women with implants, the authors sometimes conclude that there is no evidence of increased health problems. Overall, there is evidence of increased symptoms in several studies, and more research is needed to draw conclusions about the safety of implants in terms of systemic autoimmune disease.
Review articles funded by the American Society of Aesthetic Plastic Surgeons and by Dow Corning conclude that the increased risk of suicide is likely to predate implant surgery, and that women who choose breast implants are more likely to be depressed or have low self-esteem, as well as demographic traits that put them at higher risk of suicide. However, these assumptions are not supported by research data. For example, the NCI study controlled for all the demographic variables associated with suicide such as age and race and compared augmentation patients with other plastic surgery patients, who are as likely to be insecure about their appearance as augmentation patients.
Like other plastic surgery patients in an era where plastic surgery is quite common and generally accepted, patients tend to be less satisfied with the body part that they are having surgically altered, but not less satisfied with their general appearance or themselves. Among the augmentation patients, the women who had their implants removed and replaced at least once were more likely to be taking antidepressants than those who still had their original implants. Although it is impossible to determine whether the women were also more depressed prior to breast augmentation, the relationship between multiple surgeries and use of anti-depressants suggests that complications from the implants may contribute to depression.
General Health, Quality of Life, and Self-Esteem It is difficult to assess the impact of breast implants on health and mortality generally, because women who undergo breast augmentation tend to be healthier and more affluent than women in the general population.
For example, NCI researchers found a lower mortality rate among augmentation patients compared to the general population of women their age, but a higher mortality rate among augmentation patients compared to other braest surgery brezst. The authors concluded that plastic surgery patients hreast a more appropriate comparison sample, because they are more similar to augmentation patients in social class, health, joirnals habits, and other key variables. In other words, augmentation patients cost the healthcare system significantly more than other patients of the same age and geographic location. However, the research does not support this assumption.
Studies of augmentation patients show no difference or improvement in self-esteem, compared to women who do not undergo augmentation. In fact, implant patients are more likely to report that cancer harmed their sex life than women who underwent mastectomy without reconstruction. These include emotional health, physical health, general journsls, social like, vitality, and mental health. The only Medicak were in body esteem and feelings of physical attractiveness. For augmentation patients, scores on physical health and mental health were significantly worse, scores on the Rosenberg self-esteem scale were better, and there was no change on the Tennessee self-concept scores or body esteem scale.
If silicone breast implants last approximately years before breaking, replacement surgery will add greatly to the cost. The implant itself may have a warrantee for free replacement, but the surgical and anesthesia costs are not free, nor are the costs of the medical facility. These expenses may not be affordable for all implant patients, especially since the initial breast augmentation is often available on an installment plan, while additional surgeries often need to be paid for upfront. Cosmetic surgery is not covered by health insurance, and problems resulting from cosmetic surgery are usually excluded from coverage. In some states, major health insurance providers have refused to insure women with breast implants.
Some insurers have sold health insurance to women with implants, but charged them more, and some insurers have refused to cover certain kinds of illnesses for women with breast implants, or refused to cover any problems in the breast area. For women who were diagnosed with diseases that were excluded, it would not matter if those diseases were unrelated to the implants. What if a woman no longer wants breast implants? Implants can be removed and not replaced, but the breast tissue stretches from the implant, and the breast is unlikely to be as attractive as it was before the implant surgery.
According to testimony presented at the October FDA meeting, this may result in surgery that is similar to a mastectomy. Conclusions Inbreast implants had been sold for more than 25 years but there were no published epidemiological studies or clinical trials. There are now more than studies of women with implants, most of them funded by Dow Corning, implant companies, or medical associations with a financial interest in the outcome. These studies are persuasive in showing that breast augmentation does not dramatically increase the risk of diseases in the short-term. The small number of women providing relevant long-term data is especially a problem when studying diseases such as cancer, scleroderma, and lupus which take years to develop and diagnose.
Careful scrutiny of the research indicates an increase in symptoms in many studies, but it is primarily in the studies where all the augmentation patients had implants for at least six years that increases in disease risks are statistically significant. It is also notable that the independently funded studies tend to focus on women with implants for longer periods of time, and often show increased risks that are not apparent in the industry-funded studies. Diana Zuckerman and other senior staff. Medical and Health Care products Regulatory Agency.