The Supreme Court has recently announced that up to a thousand women have been given approval for a class action against The Cosmetic Institute (TCI). These are women believe they have been harmed as a result of having breast augmentation surgery at The Cosmetic Institute in Sydney.
The Cosmetic Institute has now closed but the facility continues to operate under a different name. The class action follows media exposure that many of the operations performed at TCI were by doctors who were not trained and qualified surgeons. Some of them had done a few years of surgical training, others had worked in emergency departments and all of them were taught to do breast augmentation by a plastic surgeon. They then went on to perform the surgery unsupervised.
A further problem was the operations were done under “twilight” anaesthesia rather than a full general anaesthetic. This led to overdoses of anaesthetic being given, resulting in some patients having a cardiac arrest.
What is interesting is that so many thousands of women willingly submitted to treatment at The Cosmetic Institute as they believed testimonials they read on social media, and were attracted by the low price. This is an example where good marketing was able to conceal the deficiencies in care. When everything is done in order to achieve the lowest possible price, this is likely to lead to a cheap anaesthetic, cheap implants and cheap surgeons.
It is often said that there is no such thing as “simple surgery” only “simple surgeons”! The reality is that breast augmentation is a difficult and complex surgical procedure. It is known to have many complications even when performed by skilled plastic surgeons. Complications, such as the need to return to the operating theatre because of uncontrolled bleeding; the need to perform revision surgery often in the first one or two years due to failure of the implant or malposition of the implant, are not commonly spoken about but occur all too frequently. And then of course there are the long term effects associated with the implants. Complications such as ALCL (Anaplastic Large Cell Lymphoma) an indolent cancerous condition that can develop in the capsule around textured implants (the type used at TCI). There is also breast implant illness where patients report a variety of symptoms and signs such as fatigue, muscle and joint pains, weight gain and skin conditions which often resolve once the implants have been removed. The question arises whether silicone can act as an antigen or an adjuvant to trigger certain diseases.
This is the reason why, at Avenue Plastic Surgery, we have been at the forefront of the development of fat transfer as an alternative way to increase breast size. We have now done hundreds of cases and are quite confident in our results. The technique involves harvesting of fat from one part of the body (usually the hips, thighs or abdomen) and, after preparation, grafting the fat as a living tissue into the breasts. Once the fat develops its own blood supply it is able to grow and so the breasts enlarge even more. There is no doubt that breast augmentation by fat grafting is becoming more and more common as women realise the many problems associated with breast implants. Many patients are also electing to have their old breast implants removed and replaced with their own fat for a much more natural and less problematic future.