Many more women may have defective implants

One of Costa Rica’s leading plastic surgeons said Wednesday that the use of low-grade breast implants by physicians without specialized training may mean that there are many more women in Costa Rica with potentially defective devices than health official estimates.

A government health official calculated Tuesday that there were more than 400 women in Costa Rica who had received faulty French breast implants. The calculation was based on records maintained by the national distributor of the implants made by Poly Implant Prostheses, public hospitals and some private clinics.

The implants, known as PIPs, have been known to rupture easily, and many were made with low-grade silicone that can cause infection or inflammation. The PIP implants were approved by foreign and local health officials until the Ministerio de Salud revoked the approval in the middle of last year.

But Alberto Arguello, president of the country’s association of reconstructive and plastic surgeons, said Wednesday other practitioners, posing as plastic surgeons, may have inserted the sub-par implants. While health officials claimed to have tracked the number of PIPs used in the country, some may have been purchased off the books.

“No licensed plastic surgeon would dare go and buy something in the black market,” Arguello said. “But I can’t say the same about non-plastic surgeons.” His organization is titled in Spanish the Asociación Costarricense de Cirugía Plástica Estética y Reconstructiva.

Arguello said many general physicians pose as plastic surgeons and perform operations in the country. And most of them are not trying to hide this fact either. They use prominent billboards or signs usually proclaiming buzzwords that are not recognized medical specialties and may amount to little more than a beauty parlor with cutting tools.

Arguello said the only way to be sure a physician is a trained plastic or reconstructive surgeon is to refer to a list of associated doctors on the association’s Web site,

The association’s Web site warns that the internet, yellow pages, newspapers, television and radio can be filled with offers by doctors with dubious skills.
It warns that advertisements labeled as “exclusive” offers or “fabulous” deals should be scrutinized. Reports indicate that many such ads have appeared publicizing cheap breast implant surgeries.

As an example similar to breast implants, Arguello pointed out that Botox distributors will not sell to non-approved practitioners. But yet, he said, many unapproved establishments somehow manage to get their hands on some substance that substitutes as the name-brand material to fill the syringe.

“They say they have Botox, but they don’t have the real one,” Arguello said. “Frankly, I don’t know what the heck they inject.”

Choosing a qualified surgeon may not have prevented a patient from receiving faulty implants because they were approved in the country for two years. But having picked a specialist could  facilitate removal or replacement of the implant, something Arguello said is recommended for anyone who has the PIP implant.

So far the Costa Rica government has not announced the same policy as Venezuela and France, which have committed to help with replacing PIPs for their citizens. But Costa Rican news sources reported late Wednesday that at least one public institution, Hospital San Juan de Dios, would be evaluating replacement surgeries for the approximately 130 patients who received implants.

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