Information on the consequences
of the operation
45. We also heard that women were still not being
given objective and unbiased information about the nature of the
operation and the practical consequences of a decision to undergo
surgery for breast augmentation. Ms Livsey and Ms Irwin both told
us that, when they had undergone their surgery in the 1970s they
had been told the implants would "last a lifetime".
Ms Livsey was assured she would go to her grave "with the
breasts of a young woman".
Disturbingly, things do not seem greatly to have improved in the
intervening years. Dr Sarah Myhill suggested "patients are
still being told their implants will last for life with no complications".
Ms Heasman assured us that such misinformation was still commonplace:
"Only last week I was speaking to a woman who
had been told by the company that the implants have a lifetime
guarantee. We all know - and this is a fact - that that is not
the case ... There is a great deal of misinformation and a great
deal of misconceptions and myths as well."
Ms Heasman thought that even if women were better
informed of some of the immediate, inevitable consequences of
the surgery - that they could not lift anything heavier than two
raise their arms above their shoulders, or drive
a car unless it had power steering, for at least ten days - this
would give them pause for thought. She felt they were more likely
to know about the more widely-publicised issues such as the silicone
controversy, but less likely to know of such problems as post-operative
depression or scarring. She also pointed out that "the problem
of visible rippling through the skin ... is one of the most common
problems and yet is not discussed".
46. Mr Balen thought that women should be made aware
of the true nature of problems such as haematoma or capsular contracture.
He felt that women often were not made aware that a decision to
have breast implants was usually irreversible in that the removal
of implants without replacement was often disfiguring. He thought
that one question which women should ask surgeons is "How
many operations will I require in the future?" He felt that
the absence of data made such a question difficult to answer,
but that women were potentially facing three or four operations
over a lifetime.
Professor Sturrock thought it would be helpful if patients could
access, perhaps via the internet, information on the number of
operations a particular surgeon had performed, together with details
of matters such as the infection risk.
Elsewhere in written evidence we were informed that women often
did not even know what make of implant had been fitted.
47. Patients are entitled to much more information
about the practical aspects of breast augmentation surgery. We
believe it is for the DoH to capture the data, via the Registry,
relating to the rates of rupture of different implants, and to
ensure that this information is readily available. We believe
that women are entitled to objective information on the success
rates of surgeons performing such operations and that they should
be informed of the precise nature of these surgeons' qualifications
since, as our inquiry into private healthcare revealed, there
is much misinformation in this area. We recommend that women should
be obliged to record that they have been clearly informed of all
aspects relating to future failure rate and costs of implants
as part of the fuller consent procedure we describe below.
48. We recommend that it should be mandatory that
women are given written information on the make and model of breast
implant with which they have been supplied.