Breast Implants

The Issue

Breast implants are medical devices. Like all medical devices, they provide certain benefits, but also pose certain health risks. If you are considering breast implant surgery, it is very important to understand the nature and extent of these risks before you make a decision. The decision to choose breast implant surgery can only be made by you in consultation with your doctor.

An Overview of Potential Risks Related to Breast Implants

Research the risks before deciding on breast implant surgery so that you can make an informed decision.

Breast implants are not considered to be lifetime devices. Whether implant surgery is for the purpose of reconstruction or augmentation, you will likely need additional surgeries and visits to your surgeon over time. At some point, your implants will probably have to be removed, and you will have to decide whether or not to replace them.

In addition, most women with breast implants will experience complications of some kind. These include rupture, pain, disfigurement, serious infections, and a condition called capsular contracture. This is a tightening of the scar tissue, or capsule, that the body forms around breast implants.

Before you decide to go forward with breast implant surgery, you should also consider the following:

Many of the changes to the shape of the breast after implantation are irreversible.
Removal of the implants may leave unacceptable dimpling, puckering, wrinkling, or other cosmetic changes to the breast.
Breast implants may affect your ability to produce milk for breast feeding.
Breast implants make routine screening mammography more difficult.
Breast implant surgery carries the same general risks as other surgical procedures. Check with your doctor for more information about the standard risks.

Some women believe breast implants cause systemic illnesses such as autoimmune disease or connective tissue disease. To date, there is no definite proof that this is the case.

The History of the Breast Implant Controversy in Canada

Starting in the 1960s, silicone gel-filled and saline-filled breast implants were sold in Canada for both augmentation and reconstruction purposes. The first breast implants all had smooth surfaces and relatively thick shells.

A great number of changes have been made since the introduction of breast implants in 1962. Over the years manufacturers have altered the shell strength and composition, provided barrier layers to limit gel leakage, modified valves used in saline implants and changed the thickness of the silicone gel used. These changes have been made with an aim to improve the safety and clinical performance of these devices.

In the past, scientific literature raised a number of concerns regarding possible systemic illnesses that might be associated with silicone gel-filled breast implants. On January 6, 1992, Health Canada asked manufacturers to stop the sale of these implants in Canada until further studies could be done. A similar decision was made in the United States, and silicone gel-filled breast implants were removed from general sale. Since then, a number of large studies and reviews have concluded that this was not the case. To date, there is no definite answer to this issue. The studies do, however, point out the need for women to understand the potential risks involved with breast implants. They also indicate a need for further studies to address other risks.

The Current Situation

Today, only saline-filled breast implants, with smooth or textured surfaces, are available for open sale in Canada. At this time, no manufacturer is licensed to sell silicone gel-filled breast implants in Canada. Doctors who wish to obtain silicone gel-filled implants for their patients on a case-by-case basis may apply in writing to Health Canada's Medical Devices Bureau. Each application is evaluated by Bureau staff before access is granted.

Minimizing Your Risks

Before you decide to have breast implant surgery, you must consider all of the risks, and weigh them against the potential benefits. When you finish your research, give yourself a "cooling off" period of several weeks before you commit to surgery. You and your surgeon should both sign the "informed consent" form, and you should keep a copy for your records. All breast implants sold in Canada contain a patient labelling insert, which identifies all potential risks related to breast implant surgery. You should take the time to read it carefully before making a decision.