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BAAPS response to the report of the PIP implant expert group

BAAPS support the finding of the expert group, who reviewed the risks posed by PIP silicone breast implants, and welcomes the subsequent advice from the Department of Health (DoH). BAAPS were represented on the expert group by the former President, Mr Fazel Fatah.

Current advice for patients

All patients are advised that they should be aware of the make of their implants. Those patients unsure of these details are advised to contact their surgeon/ provider. Patients are advised that BAAPS agree with the DoH expectation that patients should not be charged to access their notes. All NHS patients who have a PIP implant  should be contacted by their hospital.

The only patients who need to be concerned are patients who have PIP implants.

BAAPS agree with the following findings of the expert group:

a. There is no evidence that PIP implants are responsible for an increased rate of breast cancer.
b. The evidence provided to the group to enable assessment of rupture rates is incomplete, further data is being sought.
c. There is anecdotal evidence that the gel component of the implants is less cohesive (sticky) than most other contemporary implants,
d. There is some anecdotal evidence, supported by animal studies, that the gel has a greater potential to cause local inflammation in the tissues
e. The implication of these last two findings is that the gel has a greater opportunity to interface with the breast tissue in the case of rupture and leak, and that if it does, it has a greater potential to cause irritation and inflammatory reaction within the local tissue.

Signs and Symptoms of Rupture/Leak/Inflammation in one or both breasts

Signs may include:
Lumpiness of the breast
Lumpiness/ swelling of the regional lymph nodes in the underarms and rarely in the neck
Change in shape and size of the breast
Redness of the skin
Tenderness of the breast and or the lymph glands in the underarms
Swelling of the breast
Firmness of the breast

Symptoms may include:
Pain
Hyper sensitivity

The advice to patients is that those who experience signs or symptoms of rupture or irritation should seek advice from their surgeon earlier.
Those who do not have complaints but have concerns and wish to discuss the risks and benefits of implant exchange should also seek advice from their surgeon at some stage.

Who should you go to for advice?
Patients who had their breasts reconstructed on the NHS or had private breast augmentation with surgeons or clinics who are no longer in business will be able to be seen in an NHS clinic either following referral by their GP, or following direct invitation from their hospital department.

For patients (NHS and private) with lumps in the breast or regional lymphatic tissue
In cases where there is concern regarding the nature of the lumpiness referral should be made to a rapid access breast service.
In cases where the practitioner is confident that the lumps are associated with the implant or gel, referral should be made to the regional plastic and reconstructive breast surgery department. These patients should not require fast track referral.

For patients who have had their breast augmentation with PIP implants in the private sector and have no symptoms
You should contact your private provider and ask for a consultation. The government and all the surgical associations expect the private providers who used PIP implants to take the responsibility of duty of care towards their patients seriously and treat them with dignity and compassion.

Fazel Fatah, the former President of the British Association of Aesthetic Plastic Surgeons feels that the long held view of our Association, that it is advisable to remove or replace these implants in view of the inferior quality of the gel used in the manufacturing of the PIP implants, is vindicated, regardless of the rupture rate. Removal is advised as a precaution to prevent inflammation of the breast and the lymph glands in cases of rupture.

'We are also delighted that the Government now acknowledge the need for regulation of the cosmetic surgery sector and the establishment of a national breast implant register, two important developments that we have been campaigning for tirelessly for some time. Patient safety is the guiding principle of our Association.'

BAAPS feel that the current advice to patients takes account of both the available scientific data and the understandable anxieties of patients. Many BAAPS surgeons have already been asked to give advice to patients who have had their PIP implants inserted elsewhere, our members will continue to provide the most up to date advice, care and compassion.

Please click here for a link to the Joint Surgical Statement on Clinical Guidance for Patients and Doctors issued by the Royal College of Surgeons of England