Women with silicone gel breast implants still face agonizing questions after yesterday's recommendation by a federal panel to restrict use of the product for cosmetic reasons.
After months of controversy over the safety of the implants and yesterday's compromise proposal by a Food and Drug Administration advisory group, what should they do?
Many women have called their doctors or support groups for reassurance or advice. Others have called malpractice lawyers, some of whom are advertising heavily for clients in Baltimore and other cities.
Some women are seeking mammograms to detect any breakage of their implants, although the the X-ray carries its own risk. A few have already chosen to have the devices removed, even though the FDA panel said yesterday that they found no compelling evidence linking the implants to diseases.
One Baltimore-area woman, who weighed the evidence last October and decided to have her silicone gel implants replaced with saline-filled ones, said she thinks there has been too much waffling by health officials on the issue.
"If they're not safe, they're not safe," said the 40-year-old certified public accountant, who, like 80 percent of implant patients, had the surgery done for cosmetic reasons.
Dr. William Crawley, president-elect of Maryland's society of plastic surgeons, said the FDA's split decision yesterday "will not allay fears. If there's one thing that these hearings have done, they have, in fact, created a great deal of anxiety among women with breast implants who normally would have been fine."
"I mean it's craziness," he added. "That's the whole problem with these proceedings: They're not going on science; they're going on emotion."
Barbara Raksin, a registered nurse who works for a radiology lab and runs a breast cancer survivors' group, said many members of her group are scared by the prospect that their cherished implants could be hurting them.
"The thought of possibly having these implants taken out means they're going through the trauma [of losing a breast] all over again," Ms. Raksin said. She blames Dow Corning, the largest U.S. manufacturer of the silicone implants, for not disclosing more about the product's potential health risks.
But a 39-year-old Baltimore nurse who had silicone gel implants for cosmetic reasons 18 months ago said she is only "mildly concerned," because she hasn't heard any credible evidence that the implants pose a serious health threat. "It's upsetting to me that there's so much media coverage that's sort of hyping the whole issue," she said.
Dr. James Paskert, a plastic surgeon with a practice in Cockeysville, said his patients were confused after the FDA called for a moratorium on silicone implants last month but then told women who already had them not to worry.
"They asked, 'Gosh, how can something that is not safe enough to put in my next-door neighbor be safe inside me now?' " he said.
Jay Seidenman, a malpractice attorney whose ad seeking implant patients has appeared in The Sun over the past several weeks, said Wednesday that 30 women with silicone implants have called his office, some relating harrowing tales.
"These women are scared to death," he said. "They're literally scared to death, because it was represented to them that this would enhance their looks, make them look more womanly, and that it was safe."
Barbara Russell, a registered nurse and manager of the women's health unit at Franklin Square Hospital, said talk about the FDA's silicone gel review has dominated discussion at recent meetings of Women Beyond Mastectomy, a support group she runs.
The unease, she said, is greatest among older women who had implants in the 1970s and early 1980s, when the devices may have been less durable.
Plastic surgeons say they have been telling worried patients what the FDA panel found last night -- that there is no scientific proof that silicone gel is any more dangerous than previously thought.
"If you don't have any active problems with the implants, then there's no real need to be worried about them," said Dr. Nelson H. Goldberg, head of plastic and reconstructive surgery at the University of Maryland Hospital.