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    Breast Implants Back on the Front Pages


    Another central issue is what breast implants will be approved for. There are very clear signals that postoperative reconstructive surgery will be accepted by the FDA. It remains to be seen whether cosmetic surgery will be formally approved either for saline-filled or silicone gel-filled products.

    Of course, no matter what the products are approved for, plastic surgeons may use them for whatever purpose they feel is in the best interests of their patients. Thus, women will still be able to obtain cosmetic surgery with either saline or silicone. Moreover, breast implants still are advertised to women.

    In the letter to Bliley, FDA said that it believes that "women can evaluate the risks versus the benefits of breast implants for their personal situation if they are well informed about the rate of infection and other local complications that occur." The agency cited a study in TheNew England Journal of Medicine published in March 1997 that found that infections occurred in 2.5% of the women undergoing implants. "Other local complications include rupture, pain, ... and disfigurement, all of which may lead to medical interventions and repeat surgeries," the letter stated.

    The agency made clear in the Bliley letter that if breast implants are approved, "specific risk-related information will be provided in the product label."

    Another sure thing is that if the FDA approves the products, it will require long-term studies of safety. This is the immediate focus of the expert advisory committee meeting in early March.

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