The controversy started in France. Poly Implant Prothese (PIP), a breast implant manufacturer, was shut down when French authorities alleged that these implants were rupturing at a rate double the industry average. According to French prosecutors, PIP cut costs over the last decade by substituting a cheap industrial-grade silicone for the medical-grade silicone that is standard for the industry.

Now, French health authorities are on the horns of a dilemma: whether or not to require that French women with PIP implants have them removed. Health risks associated with these implants, if any, are unclear. If the government mandates removal, it will also pay for removal, which is a fair chunk of change when you consider that 30,000 French women have these implants. To further complicate matters, although the government will pay for implant removal it will not pay for implant replacement.

According to the New York Times, December 23, 2011, rupture or leakage of the devices has been reported in more than 1,000 of the estimated 30,000 French women fitted with these implants. But French women are just the tip of the iceberg. PIP exported 80 percent of its products, many of them to Britain, Spain and Latin America.

More than 40,000 British women are estimated to have received the company’s implants. Recently, the British weighed in on PIP implants, “There is currently no evidence to support routine removal.” They urged women with these implants to take concerns to their surgeons.

In Brazil, director of the Brazilian Society of Plastic Surgery said, “We do not have significant reports of either ruptures or rejections or even cancer associated with these PIP implants and don’t know why there is this difference with respect to the French news.”

Since none of these implants have been sold in the United States, PIP implants are a concern only for American women who had implant surgery in another country. However, this controversy highlights the need to pay attention to any product that is inserted or injected into your body. Ask your physician if the product has been FDA-approved for the purpose it’s being used for, how long it’s been available on the market and what, if any, is its history of related complications.