Increasing concern about breast implants: ‘Some of the patients are getting sick’

The silicone clinic in Amsterdam UMC was so busy last year with women who blame their breast implants for physical complaints that the waiting time had increased to a year and a half. Meanwhile, the clinic is running at full capacity and women can go to work after half a year.

Some plastic surgeons have also seen their practice fill with women who want to get rid of prostheses. And the number of explants (removal of breast prostheses) that have been reimbursed by health insurers and therefore performed for medical reasons has increased by 60 percent: from 1,411 in 2018 to 2,255 in 2019.

These are signs that more women are concerned about their implants and are seeking help. For years there has been a debate whether ‘sweaty’ silicone can make you sick. Amsterdam UMC alone saw about a thousand women with unexplained rheumatism-like symptoms, joint pain, forgetfulness, fatigue or muscle pain in recent years. These cannot be linked to implants or thick haircuts that the body has made around the prosthesis.

Consultation room

According to Prabath Nanayakkara, founder of the outpatient clinic and professor of acute medicine at the Amsterdam UMC, not enough good research has been done. Based on what he sees in the doctor’s office, he says: “We are convinced that at least some of the patients will become ill from the implants. Some people get very seriously ill. ”

In the clinic, doctors check whether it is plausible that the so-called systemic complaints are related to the silicone. About 70 percent are advised to have the prostheses removed. That almost always happens elsewhere. Two thirds of the women feel better after removal, according to one of the studies by the Amsterdam UMC.

In 2019, approximately 3,600 patients underwent breast reconstruction and approximately 8,000 women had implants placed for cosmetic reasons.

Plastic surgeon Frank Niessen from the Mittsu Institute practice has seen his work change drastically in eighteen months. Three years ago he still worked for the Jan van Goyen Clinic where he did maybe one or two explants a month, now, in his own practice it takes up 80 percent of his work. “There is more awareness, ”Says Niessen. “Last week I had a woman who no longer saw life because of the hopelessness of all the complaints. She wanted a euthanasia certificate. Until she saw a television program about implants and recognized the combination of complaints. That’s how she ended up with us. ”

Niessen understands that his professional association wants to be sure: Is this science or is there something else going on?

Shrinking haircut

Based on the scientific studies that have been done so far, plastic surgeon Marc Mureau of the Dutch Association of Plastic Surgery (NVPC) says: “We believe the use of breast implants is responsible and safe.” In only 2 to 3 percent of the explants, plastic surgeons indicated in the national breast implant registry (DBIR) in 2019 that these kinds of complaints were the cause. Most prostheses are removed because women get pain from the capsule that forms around the implant. A quarter is due to broken implants.

According to Mureau, the fact that health insurers are seeing a sharp increase in the number of explants cannot be attributed indiscriminately to the systemic complaints. “It has become easier for women to get reimbursed for an explant in 2018, something the NVPC has made strong.” That can play a part. And the number of implantations is still increasing. “If more prostheses go in, more will eventually go out.” Mureau points out that the vast majority of women have no complaints. “There are also numerous studies that indicate that breast augmentation or breast reconstruction has a very beneficial effect on the quality of life in women.”
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