Teresa Jellis has personally taken "something like 300" calls since the crisis broke, most of them within the last fortnight. Last Monday morning, the specialist cosmetic surgery nurse switched on her mobile after the weekend to search out nearly forty voicemail messages from girls concerned about their breast implants, some of them extremely distressed.
Breast augmentation has continuously been a comparatively small part of the business at Spire Healthcare's private hospital in Harpenden, a smart, low-rise compound situated on the sting of the Hertfordshire city. Of 8,000 patients treated every year, solely a hundred or so have implants, either cosmetically or for reconstruction following cancer treatment.
The hospital has records of the complete of implants used, and knows that solely 37 girls at Spire Harpenden were fitted with PIP prostheses, the French-made implants currently known to have been filled illegally with an inferior grade of commercial silicone not licensed for human use. And nonetheless the phone calls keep coming, many of them from girls who understand they were fitted with a unique build.
"There's simply a large quantity of hysteria for any lady who has had implants," says Julia Salmon, the hospital's director. "There are some terribly frightened patients out there."
This week the Department of Health took out adverts stressing "the NHS will support girls with PIP implants", and stating once more that the govt will meet the value of removing any woman's PIP prostheses if she is bothered, while stressing that there is no urgent clinical ought to do so. The Welsh government has gone more and offered to pay both for removal and replacement, although its health minister was forced to concede she did not understand what that might price.
But on the various net forums that have sprung up since December, when the French government suggested all girls with the substandard implants to have them removed, there are few signs of comfort. "The scan confirmed what I knew," wrote an ad on one Facebook cluster, "industrial silicone in my left armpit lymph nodes. Radiologist asked me if i was awake to what industrial silicone can do, at which purpose I broke down … all I can say is get these godforsaken things out your body, whatever you have to try and do."
Another commented: "I've decided to pay out to induce them removed and replaced. Gonna do it within the next twelve weeks, simply saving arduous, every little bit of money is going towards paying for this … i'm simply too scared to keep these."
Many complain of a confused and complicated image, particularly for those that don't nonetheless understand what form of implant they got. Transform, a specialist cosmetic surgery clinic that cannot say which of its eight,000 surgeries since 2001 used PIP, says it has taken five,000 calls from concerned girls since the beginning of the year.
The Harley Medical cluster, which performed thirteen,900 augmentations in total within the same period, has had to open an 11-strong call centre to cope with the amount of calls coming in.
Though the latter issued an apology to its patients in the week, admitting that "we ought to have listened earlier to your individual situations", both have resisted entreaties to interchange routinely their patients' PIPs. The Nuffield Health cluster, which will replace PIP implants for gratis, had 300 calls to merely one in all its thirty one hospitals within the 2 weeks before Christmas, in keeping with cluster clinical director Viv Heckford, and has fielded many thousands across the cluster since, albeit its surgeons performed solely 180 PIP procedures in total across the country.
Upstairs within the operating suite at Spire Harpenden, surgeon Miles Dickson remains in his inexperienced scrubs, having simply finished removing one patient's PIP devices and replace them with another complete. Like most of the opposite huge private hospital groups, together with Nuffield, BMI Healthcare, and variety of smaller operators like Highgate hospitals, Spire will meet the value of replacement on all the PIP surgeries it performed, if the woman is suffering distress and wants them replaced.
"We totally have a duty of care, and we're terribly snug with that," says Salmon. "If we say we are a premium provider, how can we differentiate this from the other procedure?"
Replacement is a easy operation lasting 20-30 minutes if everything goes to arrange, says Dickson, who is a consultant plastic surgeon at the East and North Herts NHS Trust, and conjointly does one or two of days' private work at the hospital every week.
Though he never used PIP himself, he notes, peering over half-moon spectacles in an exceedingly cramped consulting room next to the theatre, he's had "loads of emails" from concerned former patients.
His decision to use another manufacturer was largely based mostly on habit. but he says: "I have taken out a couple of broken PIP implants, before all of this occurred. and that i did explore them and think, hmm, these are not good. It's fair to say that any implant can break, and given time an awful lot of implants, even the best made, will break. Most reputable implants, once they break, don't cause a problem. These do seem to be causing a problem.
"The 2 or 3 PIP implants I even have removed, where they need been broken, are surrounded by a rather thick, pus-like fluid, [which is] continuously quite alarming for a surgeon … whereas with most implants once they rupture, you only have a trifle of loose silicone gel that's contained among the cavity that your body has fashioned around them. It's primarily a question of, that comes out, clean it out, place a replacement one in."
Breast augmentation surgery has been "trivialised", Dickson believes, and the regulatory framework that certified PIP devices as safe wasn't rigorous enough. "I believe there is a moral, moral … and medical want, actually, to get rid of these implants [even where they need not ruptured]. it's all about controlling risk. and we simply do not know at the instant what this not-fit-for-human-consumption silicone is going to try and do within the long run."
The devices he removes are "quarantined" and then sent for examination, in an attempt to assist fill out some of the gaps in what is known of their risks.
Dickson will see seven or so private PIP patients in the week, but is aware, given the inevitable lag to NHS services, that there could also be "a very little wave of patients that will come rolling through the door" for removals on the NHS.
Public hospitals are already experiencing that wave, in keeping with Sue Barter, consultant radiologist at the Cambridge breast unit at Addenbrooke's hospital. "There has been a major knock-on effect," she says.
"We are currently receiving a plain increase in referrals of women with implants, who have no plan what implants they need dawned and are currently panicking, and for many of them their original private suppliers are saying, 'We can not help you, attend your GP and say you have a lump, and he will send you up to the breast clinic'."
Though some ruptured implants, she agrees, cause the woman few issues, others will be far more problematic, with silicone – "it produces a snowstorm look on the ultrasound" – visible outside the implant capsule and within the glands under the armpit. However, she says, "implant failure is a fact", and lots of – not simply PIP – will rupture or leak after about 10 years. "But usually|this can be} often not explained to the ladies once they are place in. And really, there is an ongoing duty of care. These girls might want updating later in life."
The decision to have breast implants, Dickson agrees, is "a lifetime lifestyle commitment. If you are taking a 21-year-old who desires breast enlargement, they're in all probability committing themselves to three or four different operations throughout their lives directly regarding their breasts." For Joanna Lewis, a coach in central London, these are a disquieting few weeks. She had implants around 10 years ago, after a lifetime of feeling painfully self-conscious about her "absolutely flat-chested" frame.
She was fairly confident her implants could not are PIP, having been told at the time that her implants were a replacement kind that could not leak. "But then I read an editorial where a woman had had real hassle with globules of silicone migrating to her armpits, and she said when she had it done her surgeon had cut hers and showed her that it did not leak. I thought, holy shit, perhaps mine are not fine in the end."
She looked through her paperwork, then called her GP, but there was no record of her implant type. so she called the British Association of Aesthetic Plastic Surgeons, who referred her to the hospital where she'd had her surgery, solely to find out that it had gone into liquidation. Finally she Googled the surgeon's name, found an email address and sent off her details, to no response.
"Then i assumed, if I ring and pretend i want additional surgery, perhaps they'll ring me back. So I did, and they did." the woman on the phone told her they were receiving many inquiries every day, and to wait and see. On Thursday she received a one-line email: "I can confirm that we've got assessed your file and you are doing not have PIP implants."
"I think I even have been terribly lucky," she says. for many thousands of different girls the wait for data, and reassurance, goes on.
