Fresh worry over breast implants

Fears about the risks of silicone breast implants will be re-ignited by a review which suggests that almost all will rupture within 20 years. Jeremy Laurance, Health Editor, says there are unanswered questions about the safety of the implants used by thousands of women.

Silicone breast implants, once described as a "timebomb ticking in women's chests", may turn out to be just that, a review of research, published in The Lancet medical journal, has concluded. There is evidence that the implants, used to boost the natural assets of American film stars Demi Moore and Melanie Griffiths and the British Page Three model Melinda Messenger, become weaker with age and more prone to leak.

One study found that 11 per cent of women had a ruptured implant after eight years, half after 12 years and 95 per cent after 20 years. British experts said the findings were alarmist and took no account of improvements in the manufacture of implants over the past two decades.

David Sharpe, consultant plastic surgeon and chairman of the Breast Special Interest Group of the British Association of Plastic Surgeons, said those made since 1989 had thicker walls, with a different construction. "It is complete nonsense to suggest almost all implants will rupture in 20 years."

Manufacturers say only 0.2 to 1.1 per cent of implants rupture but estimates reported to the United States Food and Drugs Administration (FDA) have been higher. The authors of the review, Lori Brown and colleagues from the Centre for Devices and Radiological Health at the FDA, say: "There is an emerging consensus that [the rate] is much higher than previously suspected."

In Britain, about 5,000 women a year have the implants, 60 per cent for cosmetic reasons and the remainder following surgery for breast cancer. In the US, an estimated one to two million women have had them. The FDA banned silicone breast implants for cosmetic reasons in 1992, although they are still permitted for reconstructive purposes.

That ban was imposed not because the implants were known to pose a risk, but because manufacturers failed to collect information on the issue, as they were legally required to do. A decision by the main manufacturers to set up compensation funds worth more than $6bn for affected women was taken because they calculated it would save them tens of billions of dollars in legal costs, even if they were to win and not because they admitted liability.

British government reviews in 1992 and 1994 declared the implants safe but a third review ordered by the health minister, Baroness Jay, last summer and chaired by Sir Kenneth Calman, the Chief Medical Officer, is due to report in the New Year. The third review was prompted by renewed concerns over safety and over the advice given to women prior to receiving implants, a health department spokeswoman said.