A recent OP-ED appearing in the Los Angeles Times asks the question “should cosmetic surgery be banned?”
By: Carolynn Grimes
Unapproved and potentially dangerous breast implants sold overseas stir debate over the safety and risks associated with aesthetic plastic surgery.
According to the author Alexander Edmonds, the recent scandal involving unapproved and potential dangerous breast implants sold by a French manufacturer should raise questions about the safety and risks surrounding all aesthetic surgery. Edmonds received a PhD in anthropology from Princeton and has written on the social dimensions of plastic surgery. He is the author of “Pretty Modern: Beauty, Sex and Plastic Surgery in Brazil,” and is assistant professor of anthropology at the University of Amsterdam. Edmonds says, “With most surgeries, the risks are weighed against expected health improvements. But aesthetic procedures, by definition, do not improve health.”
Dr. Jeffery Kenkel, President of the American Society of Aesthetic Plastic Surgery (ASAPS) disagrees. “What would be next? Will physicians be banned from performing procedures on cleft lip children because it doesn’t prevent or cure disease?”
According to reports, the recent breast implant scandal could affect up to 300 thousand women world wide. The French manufacturer, Poly Implants Protheses (PIP) has admitted to authorities it was producing and distributing breast implants with a cheaper industrial grade silicone instead of a medical grade silicone which could be harmful according to officials. The implants have also shown to have a high rate of rupture. Edmonds says, “The fact that a surgeon is putting in implants sends a subtle message that they are safe.”
Edmonds points out that one response to the PIP scandal is a ban on doctors performing cosmetic breast augmentation altogether. He says, “It’s well known that breast implants of many types can cause burning pain, loss of sensation, hardening of breast tissue and serious infection.” Breast implant expert, scientist and Vice President of The Aesthetic Society Education and Research Foundation (ASERF) , William P. Adams, Jr, MD says he does not agree with this conclusion, “it appears he is quoting the exceptions and not the rule, in fact the science and data says when implants are used with modern techniques that outcomes are optimized, patients have very few issues and have an extremely high degree of satisfaction.”
The FDA says both saline and silicone breast implants in the U.S. are safe.
He quotes the FDA’s 2011 ‘Update on the safety of silicone gel-filled breast implants’, which states that: “Frequent complications include implant rupture, wrinkling, asymmetry, scarring, pain, and infection, among others.” But Kenkel says, “That’s not true.” Last year the FDA (Food and Drug Administration) concluded that the silicone-gel implants are safe as long as women understand they come with complications. According to Kenkel, “Breast implants are one of the most studied medical devices in the history of the FDA. Both saline and silicone implants that are manufactured in the U.S. are safe.”
However, Edmonds says the FDA made clear that local complications are not uncommon. He quotes the FDA’s 2011 ‘Update on the safety of silicone gel-filled breast implants’, which states that: “Frequent complications include implant rupture, wrinkling, asymmetry, scarring, pain, and infection, among others.”
Kenkel says Edmonds is confusing the issue of an unethical manufacturer using non-medical grade silicone and the legitimacy of plastic surgery. “When surgery involves a medical device that was fraudulently manufactured, it’s more logical to question the manufacturer than question the patient’s motivation for wanting the surgery.”
Dr. Leo McCafferty, President Elect for ASAPS says, “Cosmetic Surgery, if performed by a board certified plastic surgeon in a properly licensed and accredited facility has never been more safe.” Dr. Adams agrees. He says, “If we look at the benefits of cosmetic and plastic surgery procedures to patients, it’s very well documented that patients have incredible elevation of their quality of life, and there’s data to support that.”
From 2009-2010, there was almost a 9% increase in the total number of cosmetic surgical procedures, with over 1.6 million surgical procedures this year, according to ASAPS. It is also reported that the number of breast augmentations alone have tripled during that same time frame with a 90% plus satisfaction rate.
Edmonds says his goal in the piece was to add to the already extensive debate about the risks of cosmetic procedures and whether consumers are adequately informed about them. Drs. Kenkel and Adams , both Board Certified Plastic Surgeons in Dallas, Texas, agree that patients need to be more educated on procedures and say patient education by qualified Board Certified Plastic Surgeons is a top priority in their practices. In the end, they say, an informed and educated plastic surgery patient results in a better outcome for the patient.
McCafferty states that anyone considering plastic surgery should “seek properly trained Plastic Surgeons certified by the American Board of Plastic Surgery and members of ASAPS and ASPS (American Society Plastic Surgeons). These surgeons operate in accredited, licensed facilities using safe effective FDA approved products, devices, implants and equipment.