Manchester Plastic Surgeon Series Breast Implants Exchange by Dr Apostolos (1)

Exchange of your old PIP breast implants

Over the last 3 months, a few ladies have visited Reflect Clinic wishing to have their old PIP breast implants removed and replaced with the new generation silicone ones. They didn’t know each other but they had two things in common: firstly, they all had them inserted before 2010 and secondly, they have all had problems with them. Actually, they now have two more things in common: they have had their operation, so they no longer have the old breast implants and are enjoying great new boobs!

Based on our recent clinical experience, we decided to write this blog with the view of educating you further regarding the PIP implant story. PIP stands for Poly Implant Prosthesis, a French company manufacturing breast implants. They launched their first breast implants in 1991 and soon after the company became the third biggest distributor globally.

PIP breast implants

PIP implants rapidly invaded the UK market and due to strong marketing and competitive prices, they became really popular. However, from 2002 till 2009, more than 250 cases of adverse incidents were reported, challenging the safety of these particular implants. In 2010, they were withdrawn from the UK as it was found that they contained unapproved silicone gel and therefore was a massive scandal in the world of cosmetic surgery where safety and robust testing procedures are both paramount.

It is estimated that 47,000 women had breast augmentation surgery with PIP breast implants in the UK, either in private practice or in the NHS. Obviously, all of them were inserted in the 90s and the 2000s, before 2010. A large proportion of them still have the PIP implants fitted, making them at least 13 years old today. It is quite interesting that some of these patients do not even know that they had been given PIP breast implants while some others cannot even access or gain information about them anymore due to the long timespan.

Back in 2010, upon investigation, these implants were deemed unsuitable for breast surgery as they were found to be prone to rupturing and compared with breast implants from other brands, two to six times more likely to rupture.

After the scandal broke out, the French government recommended that all women with PIP implants should have them removed. However, the Medicine and Health Products Regulatory Authority (MHRA) in 2012 subsequently concluded that they do not raise any concerns regarding risks to the patients’ health. This decision has been challenged a lot but up till today, however, there has been no scientific proof to link the filler of the breast implants to cancer or increased toxicity.

Reasons to have your breast implants exchanged

Coming back to our recent experience, only one of our patients had both implants completely ruptured along with contracture of the capsule and moderate symptoms, including pain and discomfort and change in the breast shape. Our other patients presented with various grades of contracture (tightening and scar tissue around the implant) and therefore significant aesthetic alterations. This is to be expected if one thinks that some of these breast implants have been inserted more than 15 years ago. Therefore, after so many years of having PIP implants, patients coming in to the clinic can present with:

• Rupture of the breast implants, either symptomatic or asymptomatic
• Breast asymmetry
• Contracting of the breast implant capsule(s) with various symptoms
• Hardening of tissue or other material around the capsule (Calcification)
• Droopiness of the gland(s) over the breast implant(s)
• Abnormal position of breast Implants (malposition) either higher or lower (inferiorly) or to the side (laterally)

From the Cosmetic Surgeon’s perspective, exchange of the PIP implants with new ones can be very challenging and requires quite a lot of experience and careful planning. The surgery can be very demanding, similar to breast reconstruction. During the operation we have to deal with the pathology (causes and effects of any samples of unusual body tissue for diagnostic or forensic purposes) of an old breast implant:  it can be ruptured with filler pouring into the pocket which needs copious washing and thorough removal of all parts; the old capsule might be severely contracted and calcified, requiring removal and extensive “release” of this tightening. A new pocket must be created in such a way that welcomes a new and modern breast implant nicely, with the intention of staying as long as possible. Finally, the breast has to be uplifted and/or reduced to correct the effect of the gravitating forces, giving a beautiful shape.

If you still have PIP implants but you are not happy with the way your breast looks after so many years, or you have signs of breast implant rupture or of if you simply think that it’s time they were exchanged, speak to us. We can see you in our clinics, chat and assess how your old breast implants sit on your chest wall and discuss any potential issues now or in the future. We can then talk you through the new generation of safe implants and the various techniques that we will use to achieve a brilliant result for YOU.