Breast enlargement surgery is performed by placement of saline or silicone filled implants, in a silicone shell, under the skin and muscles of the chest.

Breast augmentation has been performed on millions of women since its inception in Houston in 1963 by Dr. Frank Gerow, who was my professor when I was in training there. Now there is trouble for the French maker of silicone implants, PIP, Poly Implant Prothese.

In the 1980s, there were a number of breast implant manufacturers in the world. Most of them here in the United states.  Each company touted its own particular take on the breast implant market. Some had shaped implants, other covered them in polyurethane etc.

By 1990 a movement had begun, ironically also based in the birthplace of the breast implant, Houston ,Texas,  that associated silicone implants with a number of medical problems. These diseases tended to be auto-immune diseases (where the body attacks itself) which are by nature more common in women. They include diseases like Rheumatoid arthritis and Lupus . It was thought that these disease may be caused by silicone coming in contact with our bodies.

After ten years of research, no association has been found between breast implants and auto-immune disease, yet the initial ban implemented by the US government in the early 1990s was enough to cause the downfall of Dow Corning, one of the major breast implant manufacturers amongst others. Breast implants became the most studied medical device in history.

The upshot of all of this was that only two manufacturers remained in the US, and new manufacturers started in other countries like France. The PIP company breast implant was one of these new entrants into the market. Being was outside of the US FDA paws, they began to sell their implants all over the world. In fact 84% of their implants were exported to South America and other western European countries. They never were allowed to sell in the US and the FDA had not cleared them for concerns of safety ten years ago!

Last week the PIP company came under international investigation for faulty manufacturing processes with over 100 Dutch women having had silicone implants that are failing by rupture and oozing of silicone. PIP has gone POP.
The company that was set up by a supposed French butcher ( although that particularly curious innuendo has since been denied) is accused of using industrial strength silicone- as in what you use around your windows for caulking- in their implants. Medical grade silicone is much more expensive and in these hard times…….

So this is a case of a bad grade of silicone being used for breast enlargement implants. The fact remains that silicone breast implants, used by cosmetic plastic surgeons in the United States, are safe. Doubtless many cosmetic patients may become afraid of silicone implants again, but hopefully science will prevail and their safety reasserted.