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Recently, I have started to see patients at my Toronto plastic surgery practice, to have their PIP breast implants removed. All of these women had their breast augmentation surgery performed abroad. The PIP implants were never approved for use in North America, so patients who had breast augmentation performed in Canada should not be alarmed.


Poly Implant Prosthese (PIP) breast implants have been a subject of major concern for women around the world over the last few months. The French company is accused of manufacturing breast implants with industrial grade silicone gel, instead of a much higher quality medical grade silicone. There is concern that these implants have a higher rupture rate, and that the silicone inside these implants may release toxic substances if a rupture were to occur.

On December 23, 2011, the French government recommended that the estimated 30,000 women in France with PIP implants seek surgical removal. On January 6, 2012, the British government has also stated that it would pay for women who require the implants removed (if deemed medically necessary), for the estimated 30,000-40,000 women in Britain who have PIP implants.

Surgical Options for PIP Breast Implant Removal

The goal in removing these implants is to do so en bloc. This means that the breast implant and surrounding scar tissue (the capsule) is removed as one single unit. The implants are not traumatized in any manner during the surgery, to minimize the possibility of leakage during the removal procedure.

Some women may choose to have new implants replaced at the time of removal. The replacement implants in my practice (made by Allergan or Mentor) are all approved by Health Canada, the Canadian equivalent of the FDA. Patients have a choice of saline implants, silicone implant, or ‘gummy bear’ silicone implants. They may also opt for a different size when replacing the implants.

Patients may choose to have a breast lift (mastopexy) instead of replacing the implants, if they are concerned about the sagging that may occur due to implant removal. Combining a breast lift with implants is another option.

What to do if you have PIP Implants

Patients who have PIP implants should contact a plastic surgeon to discuss their options. This is especially important if they have signs and symptoms of rupture (such as breast firmness, change in breast shape, breast implant appearing higher on the chest, breast pain, or breast feeling cold when going outdoors).