Las prótesis de silicona no son para toda la vida · ELPAÍS.com

Las prótesis de silicona no son para toda la vida · ELPAÍS.com: "Las prótesis de silicona no son para toda la vida
Las autoridades sanitarias aconsejan cambiar los implantes mamarios cada diez años

AGENCIAS 22/06/2011 [BLOG incluye el comunicado oficial de la FDA]

'Los implantes mamarios no son dispositivos de por vida'. Así de tajante ha sido Jeff Shuren, director del Centro de la FDA para Dispositivos y Salud Radiológica en relación a un informe sobre la seguridad de las prótesis de pecho que ha difundido hoy la Administración de Alimentos y Drogas (FDA). El estudio defiende que los implantes silicona son fiables, a pesar de las complicaciones que pueden ocasionar a largo plazo. Según las estimaciones de este organismo, una de cada cinco mujeres tendrá que cambiar su prótesis diez años después de que se la implantaran.

Shuren ha recomendado estar alerta ante 'cambios inusuales' y someterse a un seguimiento médico del estado de los implantes, que incluya resonancias magnéticas rutinarias para detectar rupturas silenciosas. También ha adviertido que 'cuanto más tiempo tenga el implante, más probabilidades hay de tener problemas'. Las complicaciones más comunes que ha detectado la FDA son el endurecimiento de los tejidos e insensibilidad del seno en la zona donde se encuentra el implante, la ruptura o aparición de arrugas en la envoltura, asimetrías entre dos implantes, cicatrices, dolor, e infección en el lugar donde se produjo la incisión.

Se trata de la primera evaluación que hace la agencia sobre las prótesis de silicona desde que los agentes reguladores autorizasen su comercialización en noviembre de 2006 para las mujeres de más de 22 años, tras 14 años de prohibición. La FDA retiró los implantes de silicona en 1992, basándose en la premisa de que los fabricantes no habían aportado datos médicos que confirmasen su seguridad y efectividad. En aquel momento, se barajaba la posibilidad de que el gel de silicona estuviese relacionado con la aparición de cáncer de mama, lupus, problemas reproductivos o artritis reumatoide, pero estos riesgos que se han descartado.

La garantía de seguridad de la Administración de Alimentos y Drogas se basa principalmente en los estudios de dos fabricantes de implantes: Allergan y Johnson & Johnson. El Centro Nacional de Investigación para Mujeres y Familias de Estados Unidos no confía en estos informes, ya que considera que la mayoría de los estudios son incompletos y que no representa a la mayoría de las mujeres que llevan una prótesis de silicona. Solo el 58% de las mujeres inscritas en el estudio siguen representadas en él después de dos a tres años, de manera que su evolución no aparece reflejada. 'Una vez que el producto tiene luz verde para salir a la venta, los fabricantes no tienen incentivos para continuar adecuadamente lo estudios requeridos', declara Diana Zuckerman, doctora de este centro.

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Silicone Gel-Filled Breast Implants: Updated Safety Informatio​n

When the Food and Drug Administration allowed silicone gel-filled breast implants back on the market in November 2006, the agency required the manufacturers to conduct follow-up studies to learn more about the long-term performance and safety of the devices.

Today, FDA released a report that includes preliminary safety data from these studies, as well as other safety information from recent scientific publications and adverse events reported to FDA.

FDA approved silicone gel-filled breast implants for increasing breast size (augmentation) in women age 22 or older and for reconstruction (after breast cancer surgery or other medical issues) in all women. They are also approved for revision surgeries, which correct or improve the result of an original augmentation or reconstruction surgery.

Almost five years later, FDA’s report continues to support the safety and effectiveness of these implants when used as intended, but states that women should fully understand the risks before considering getting them.

Breast implants are not lifetime devices. The longer a woman has them, the more likely she is to have complications and need to have the implants removed or replaced. Women with breast implants will need to monitor their breasts for the rest of their lives.

The most frequently observed complications and adverse outcomes are tightening of the area around the implant (capsular contracture), additional surgeries, and implant removal. Other complications include a tear or hole in the outer shell (implant rupture), wrinkling, uneven appearance (asymmetry), scarring, pain, and infection.

Studies to date do not indicate that silicone gel-filled breast implants cause breast cancer, reproductive problems, or connective tissue disease, such as rheumatoid arthritis. However, no study has been large enough or long enough to completely rule out these and other rare complications.

FDA is working with the two manufacturers who make silicone gel-filled breast implants, Allergan and Mentor, to address the challenges in collecting follow-up data on the women who have received these implants.

“It is important that women with breast implants who experience any symptoms see their health care providers,” says Jeffrey Shuren, M.D., J.D., director of FDA’s Center for Devices and Radiological Health. “Women who have enrolled in clinical studies should continue to participate so that we can better understand the long-term performance of these implants and identify any potential problems.”

FDA also provided other information today on both silicone gel-filled and saline-filled breast implants:

- A redesigned website on breast implants at www.fda.gov/breastimplants

- A booklet, “Breast Implants: Local Complications and Adverse Outcomes”, which highlights the most common problems that occur with breast implants and things to consider before having breast implant surgery. [http://www.fda.gov/downloads/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/UCM259894.pdf]

- A handout with questions to ask your surgeon before getting breast implants [http://www.fda.gov/downloads/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/UCM259894.pdf]

- Two videos on a small but increased risk of a rare type of cancer called anaplastic large cell lymphoma (ALCL) in women with breast implants: one for women (www.youtube.com/watch?v=Nw79yIQOlhk) and one for health care providers (www.youtube.com/watch?v=_D6Yku4uEFc)

FDA recommends that women with silicone gel-filled breast implants do the following:

* Follow up. Continue to routinely follow up with your health care provider. Get routine MRIs to detect a rupture that you may not be aware of (silent rupture). FDA recommends that women with silicone gel-filled breast implants get screenings for silent ruptures three years after they get implants and every two years after that.

** Be aware. Breast implants are not lifetime devices. The longer you have breast implants, the more likely you are to have complications. One in 5 patients who received implants for breast augmentation will need them removed within 10 years of implantation. For patients who received implants for breast reconstruction, as many as 1 in 2 will require removal within 10 years of implantation.

*** Pay attention to changes. Notify your health care provider if you develop any unusual signs or symptoms. Report any serious side effects to the breast implant manufacturer and MedWatch, FDA’s safety information and adverse event reporting program. Report online at www.fda.gov/MedWatch or by calling 800-332-1088.

**** Stay in touch. If you’re enrolled in a manufacturer-sponsored study, continue to participate. These studies are the best way to collect information about the long-term rates of complications.

fda full-text and related documents:
Breast Implants







Breast implants are medical devices that are implanted under the breast tissue or under the chest muscle to increase breast size (augmentation) or to rebuild breast tissue after mastectomy or other damage to the breast (reconstruction). They are also used in revision surgeries, which correct or improve the result of an original surgery.

There are two types of breast implants approved for sale in the United States: saline-filled and silicone gel-filled. Both types have a silicone outer shell. They vary in size, shell thickness, and shape (contour).

The information provided on this website is designed to support, not replace, the relationship that exists between a patient and a physician. We have provided this information to:

.Help women make informed decisions about whether or not to get breast implants.
.Explain the risks of breast implants and describe the surgical procedures used to implant them.
.Provide information on saline-filled and silicone gel-filled breast implants, including data supporting a reasonable assurance of safety and effectiveness, approval letters, labeling and information on post-approval studies.
.Provide information on reports of anaplastic large cell lymphoma (ALCL) in women with breast implants.
.Outline the history of regulatory breast implants in the United States.
.Encourage reporting of adverse events associated with breast implants through our Medwatch Reporting System.

Breast Implants