- This investigation is part of a global media collaboration with News CBC, Radio-Canada, Toronto Star and the International Consortium of Investigators Journalists who explore tens of thousands of medical devices and how They are made, approved and monitored by regulators worldwide.
- Find out more about your medical device by searching the WBQ News database of the Health records of Canada.
The disorders listed on the medical chart Nikki Carruthers read as follows: blackouts, memory loss, slip, vomiting, thyroid problems, angina, high blood pressure, heart palpitations, high blood pressure, pig, pain in the chest, ulcers, depression, anxiety and flooding that stays in bed for at least 18 hours a day.
Carruthers, 29, was rarely seen inside the doctor's office until 2013, when he decided to have breast implants. The following cascading health issues have triggered dozens of visits to hospitals and doctors.
"My body was all closing down," said the Winnipeg woman, who has failed to work since July. "My austerity burns a [it] hurt to swallow. He feels that someone sits on my quest when I try to breathe. "
The leading driving machine & global industry implants of $ 1 billion runs on ambitious inspirational images of perfect bodies, bright testimonials and inspiration from celebrities – but in many cases there is little mention of the potential risks, the Marketplace Star / CBC Marketplace inquiry, in partnership with the International Consortium of Journalists of Investigation, has found.
Breast addition is the most popular cosmetic surgery in the world, with 10 million women choosing for breast implants during the past decade. Most have not reported adverse health issues, and some studies refer to high satisfaction rates. Producers emphasize that many studies have existed over the years that have shown that their products are safe.
But Carruthers is among the growing number of women across Canada who have suffered health complications that they believe are related to their breast implants. They also believed that they had been misled by surgeons who recalled that the health concerns of the 1990's had been addressed more than a decade ago.
There is no cause-and-effect directly associated with implants with some of the symptoms described, but research has linked to textile implants to rare cancer known Large anaplastic cell lymphoma associated with breast implantation, or BIA-ALCL.
Since Monday, the ICIJ has heard from more than 540 women responding to online demand for responses to the global series of stories on breast implant health issues. Among the 45 Canadians who responded, women complain about infections, hair loss, body inflammation, muscle weakness, breathing difficulties, neurological issues, self-suicidal thoughts and implantation.
Promotion of implants
A review of 25 websites related to plastic surgeons in the Toronto area shows plenty of magnificent images but very little details of the adverse outcomes associated with breastfeeding.
Underground visits to Toronto's three plastic surgeons by the WBQ The Marketplace producer – who owned prospective patients – revealed sales techniques, some of which were a leading medical scientist of "very tough" name.
At age 23, dissatisfied with her body's image, Carruthers came up with $ 6,300 – having funded through a line of credit – for breastfeeding.
It seemed safe and easy. He said a little about the medical risks beyond the standard notices associated with any surgery.
"He was made as if he was rid of it," he said. "He told me that there were only very few cosmetic risks that would be repaired in a touch procedure if something was going out of place."
Nikki Carruthers explains why he decided to start breastfeeding initially:
The message on the plastic surgery websites she visited was full of promises of confidence and perfection.
Any health problems have undermined any excitement for her new body soon, said Carruthers, who had the implant surgery in 2013.
Just over a year later, she had a second surgery to relieve serious pain in her chest. The implants were lowered and lowered too low on their chest.
Although the province or provincial protection body does not require informed consent for each separate medical procedure, A principle that is intended to ensure that patients are fully aware of the potential outcomes.
No standard script surgeons are used to inform patients of the risks. All doctors have their own approach.
You need to understand & # 39;
When the The market producer asked for a recovery time in the three clinics that she visited, the answers ranged from 24 hours to six weeks.
"We can go out for lunch and night after surgery, we can take you to the beach the next day," said Dr Mahmood Kara.
When asked to explain the specific technique, Kara replied: "You do not have to understand, I just need to know what I can achieve, and I've done it on thousands of patients."
The University's biologist of Toronto, Kerry Bowman, says that the response fails to provide the necessary knowledge that the patient has informed consent.
"That would worry me, because you need to understand," said Bowman. "Ethically and legally … you have to have an able patient and needs to understand and appreciate all the full risks."
The introduction of medical risks associated with breast implants is also a matter of concern.
During the consultation, Kara outlines what is commonly known as the general risks of the surgery, such as bleeding, infection and internal scratches around the impiate, which is called a capsule contract.
But on his website, Kara calls her "myth" that implants leak into the body if they are broken.
Dr. Jan Willem Cohen Tervaert, director of rheumatology at the University of Alberta medical school and co-author, has a number of studies that show links between breast implants and automatic illnesses, says research is being challenged by research.
"There are enough publications that show a drop of silicon with new implants," he said.
In a list that outlines the risks of implants, the The United States Food and Drug Administration also indicates that a silicon gel of devices has been able to migration away from the breast.
Kara rejected repeated requests for interviews.
Consent forms can be difficult
In the clinic of a plastic surgeon Dr. Martin Jugenburg – known as Dr. 6ix on its website – the journalist asked for a copy of the consent form that describes the procedures, surgical risks and post-op instructions that she would have to sign before making the decision and provide a deposit of $ 2,000 to order the surgery.
"I do not think I've allowed me to do it for some reason," said a clinic nurse, although she provided the consent form later.
"I'm surprised that there is so much pressure on the consent forms," said Bowman after reviewing Market camera camera. "I think that you have to pay beforehand is a very ethical problem."
In a written response, Jugenburg said that his patients do not require patients to pay to see or receive consent forms.
"This was not clear during the visit of your researcher, and as a result of your feedback, I made sure in the future that there will be no confusion."
In the third Toronto clinic she was visited On the market, Dr. Sean Rice spent time describing the implant surgery itself. Her nurse gave a long consent form and told the producer she would have to take her home and read, and then contact the clinic if she had questions or concerns.
In an email to Rice said, "I want to ensure that all patients understand the risks associated with their full surgical procedure. I offer an opportunity to discuss the consent form after review to allow any subsequent questions before the surgery. Patients deserve time to evaluate and question permission before approval ".
Bowman believes that time for patients to reflect on the decision they make is essential, although there is no prescribed period to outline in college documents for doctors.
A variety of surgical dates were offered to the Marketplace producer in the three clinics visited: 24 hours after the consultation, four days later, and a few weeks later.
Pictures before and after
The vast majority of plastic surgeon websites include "pre-post-" references and images that appear to break the provincial legislation and the policies of the College of Doctors and Ontario Surgeons.
"Where we were told about the use of past and past photos in the past, we have kept that they constitute references contrary to the regulation," said college spokesman Shae Greenfield, stating that the regulator have punished doctors for doing this.
Last year, the Kara college warned about using pictures before and after in a magazine advertisement.
"Given the repeated breach of advertising policy and regulation, the [college complaints’] committee was satisfied that it would change its behavior without further guidance, "the decision reads.
But a prominent comment on its website today contains more than 260 pre-and-post pictures of plastic surgery procedures.
Jugenburg is currently facing a pre-college disciplinary hearing, who claims to have committed professional misconduct for advertising methods, including allowing a film crew to a surgical procedure without the patient's consent, making "inappropriate" use of images that posted "before and after-on-going on its unanswered social media accounts," as well as "pressing her to follow and contribute to her social media accounts."
In a written response, Jugenburg said that the allegations were "rejected and protected."
The use of "pre-and-" images "in general" in medicine, wrote, and the images provide "relevant public information, as patients perform their research themselves on the internet, demand more transparency … and more self-directed decision-making. "
DeerThe Jugenburg website currently has more than 250 pre and post pictures for a variety of plastic surgery procedures.
Some plastic surgeons separate the use of post and post images.
Toronto's plastic surgeon, Dr Leila Kasrai, explains on her website why she does not do that: "Due to the Ontario Medical Doctors and Surgeons advertising regulations placed on all doctors in Ontario, we can not display photographs and references from & # 39; n patients. "
Choosing an assault
Ultimately, the worsening symptoms eventually led Nikki Carruthers to get a third breast surgery last September: This time to get rid of implants even though she was never had a clear diagnosis that attributed his symptoms to the implants.
When they came out, a discovery: The correct implant was broken and both implants showed a capsule contract, according to an analysis of the implants taken by Pierre Blais, a former adviser and a pharmacist of Health Canada who now runs the Ottawa company which is a proven device.
"This type of rubbing is common and it's … material fatigue," his report reads. "The result of trauma or accidental … is not harmful."
In an interview, Blais said Carruthers' correct attack barrier, which was "broken into four parts," was almost unique.
"When you look at the instructions to use for this product … it says that rupture can happen," said Blais. "Not really. They should say that rupt will happen – it depends on how long you have. "
Carruthers said Blais's perceptions were a dream. "My treaties were correct. I did not get mad."
Since it ended, Carruthers said that the liver tumor had broken. But it has not yet returned to the work due to pain and tiredness, cognitive impairment, concentrations and autonomous symptoms.
"I can not imagine how many women are currently available … without thinking about what's in place, feeling desperate and mad," he said. "The whole thing calls me a stomach every time I'm thinking about it."