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The Silicone Controversy : Health: Activists take offensive against breast implants, alleging health risks; many doctors, manufacturers say they're alarmists.

December 04, 1990|LESLIE BERKMAN | TIMES STAFF WRITER

For years, Marie Walsh, a Laguna Hills mother of eight, watched her health deteriorate. She was plagued with fatigue, abdominal pains, irregular menstrual periods and night sweats.

Then one morning in February of 1984, she awoke and found the front of her nightgown damp with a bloody gel. A surgeon found that an implant in her left breast had ruptured, spilling silicone gel over the breast cavity. He cleaned out as much of the gel as he could and put in a new implant.

But Walsh's problems worsened.

She needed multiple surgeries to replace later implants that hardened uncomfortably and to remove silicone-filled tumors . She starting developing a variety of debilitating diseases: rheumatoid arthritis that made it painful for her to walk; scleroderma that tightened her skin and made her hollow-eyed, and chronic lymph, kidney and liver problems.

"I'm disintegrating," she said. "It's just a question of time (as to) what is going to go next."

Walsh and her doctor are convinced that silicone gel from the implants has migrated through her body and caused chaos in her immune system.

Earlier this year, Walsh won an $80,000 settlement against the manufacturer of the ruptured breast implant and that publicity has spun her into the center of an emerging nationwide network of women who allege that implants pose health hazards that are being kept a secret from consumers.

She and other activists are crashing seminars on breast augmentation, courting newspaper and television reporters and filing lawsuits to draw attention to their plight.

Their fears are considered irrational by manufacturers of breast implants and most plastic surgeons, who contend that the devices' benefits--primarily that of boosting a woman's self-esteem--outweigh the risks. They say there is no scientific evidence to prove any link between breast implants and cancer or diseases that attack the immune system.

Dr. Garry Brody, a clinical professor of plastic surgery at the University of Southern California and chairman of the society's plastic surgery device council, complained that the women in the Command Trust Network are discouraging women who would benefit from breast implants by "spreading panic."

Brody said a USC study is following more than 3,000 women in Los Angeles County who have had silicone breast implants and discovered so far that they have no higher incidence of cancer than the general public.

But breast implants are becoming increasingly controversial.

Safety concerns have prompted the U.S. Food and Drug Administration and its Canadian counterpart to call for further investigations and to collect test data from manufacturers.

Critics of breast implants have in their corner a Ralph Nader-founded advocate organization, Public Citizen Health Research Group, which has demanded that implants be taken off the market and has sued the FDA for access to manufacturers' records.

The stakes are high. An estimated 2 million U.S. women have had breast implants, which are being performed at a rate of about 130,000 a year. About 85% of breast implants are cosmetic. The rest are performed to reconstruct breasts after cancer surgery.

Said Dr. William Shaw, chief of the division of plastic surgery at UCLA Medical Center: "It could be a bigger problem waiting to be confirmed or a smaller problem with a great deal of hysteria."

At the center of the controversy are devices that look like sacks made of a rubbery silicone skin and filled with silicone gel.

They were designed by two plastic surgeons from Houston looking for an alternative to plastic sponge implants, used since the 1930s, which were unacceptable because they made the breast very hard and frequently caused allergic reactions.

Doctors also were injecting silicone liquid directly into women's breasts, in some cases causing severe health problems, but the FDA stopped that practice in the early 1960s.

The first silicone-gel devices were implanted in 1963, and they have become especially popular in recent years as fashion and films have stressed the larger-breasted look. Advertisements in women's magazines and newspapers have enticed women with the purported ease of the procedure, which costs $2,000 to $5,000.

Silicone gel is used in the implant to give a natural feeling to the breast; the sack is designed to prevent the gel from getting into body tissue.

However, it quickly became obvious that the device had problems. Patients complained about excessive scar tissue building up around the implant, making the breast unnaturally hard and causing pain. This condition occurs in 30% to 50% of breast-implant patients, many of whom have repeated surgeries to try to correct it.

Also, it is generally conceded that implants can hamper efforts to detect breast cancer through mammography.

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