STEVE INSKEEP, host:
Next for you, the latest safety information about the top cosmetic surgical procedure in the United States - breast augmentation. Last year, silicone implants were used in 60 percent of those operations.
Back in the '90s, you may recall those implants were pulled off the market because of safety concerns. Years later, the Food and Drug Administration said the implants posed no serious health risk. Then, about two weeks ago, the FDA offered new safety information drawn from ongoing studies.
Reporter Gretchen Cuda-Kroen has the story.
GRETCHEN CUDA-KROEN: The FDA report says silicone implants are generally safe, but complications from implants are frequent: things like hardening of the skin around the implant, ruptured, wrinkled, or lopsided implants, scarring, pain and infection.
As many as half of patients will need to have additional surgeries or have the implants removed in the first decade. It also turns out the longer a woman has the implants, the more likely she is to experience these complications.
Take Kate Marion, she had silicone implants for breast augmentation in her late 20s, and just shy of two decades later, she noticed something unusual.
Ms. KATE MARION: I noticed that when I was crossing my left arm across my body, I would make a little noise from my armpit, the way little boys do when they stick their hand in their armpit and pump their arm up and down.
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Ms. MARION: Little tooty noise.
CUDA-KROEN: An MRI showed both her implants had burst. Her doctor immediately recommended removing them, which she did. Marion hasnt suffered any apparent harm from her ruptured implants, and she even confesses to having an occasional twinge of regret that she didnt have them replaced when she had the old ones removed. But ultimately, she decided she didnt want to go through more surgery.
Ms. MARION: Well, how long would these next one last? I'd be in my 60s when I had to do this again. Who wants to have surgery, unnecessarily, when you're 60-something/
CUDA-KROEN: New York City plastic surgeon, Matthew Schulman, says, with current implants, that leaking is not a health threat.
Dr. MATTHEW SCHULMAN (Surgeon): The actual silicone thats within the implants is inert. So if the silicone gel leaks, it doesn't travel through the body, it doesn't cause systemic problems, so the MRI is really detecting a cosmetic concern.
CUDA-KROEN: There have been more serious outcomes. Annette Knecht got silicone implants in 1991, following a double mastectomy. For years afterward she felt ill, suffered multiple bouts of pneumonia, had trouble breathing and pain in her chest. Doctors reassured her it wasnt her implants.
Ms. ANNETTE KNECHT: We had a CT scan done, and it showed okay, everything showed fine, so we didn't worry about it.
CUDA-KROEN: But no one ever told her to get an MRI, something the FDA now recommends women with silicone implants get every few years. It turned out that Knecht's implants had leaked and a biopsy found silicone in her lymph nodes, and in her lungs. She is currently disabled and awaiting a lung transplant all, she says, for vanity.
Dr. SCHULMAN: We're about four generations removed from that implant.
CUDA-KROEN: Matthew Schulman says silicone implants have undergone big changes since the early 90s when Knecht received hers. He says back then, they contained a runny liquid silicone.
Dr. SCHULMAN: The silicone implants of today, its essentially like a jelly, so the jelly may ooze a little bit, but it will not run out like an oil.
CUDA-KROEN: There are plenty of satisfied customers among the nearly 400 thousand women who receive breast implants each year. Even so, Schulman tells his patients additional surgeries are a very real possibility.
Dr. SCHULMAN: I say youre young, breast implants don't last forever. They may leak, they may rupture, you may decide you want a different size, so you have to at least expect that sometime in your life you are going to need a re-operation. And if you are 100 percent against having another surgery in your life, related to these implants, then its something you should reconsider.
CUDA-KROEN: For NPR News, Im Gretchen Cuda-Kroen in Cleveland.
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