- This investigation is part of global media co-operation with CBC News, Radio Canada, Toronto Star and Washington's International Investigative Journalists Consortium, which examines tens of thousands of medical devices and how they are developed, approved and monitored by regulators around the world. .
- Find out more about your medical device by searching for Canadian Canadian entries in the CBC News database.
The diseases listed on the medical map for Nikki Carruthers include: memory loss, memory loss, fainting, vomiting, thyroid disorder, angina pectoris, hypertension, palpitations, high blood pressure, migraines, chest pain, ulcers, depression, anxiety and exhaustion that keeps her in bed at least 18 hours a day.
Carrot, 29, had just seen the inside of the doctor's office until 2013, when she decided to get breast implants. The following cascade health issues caused dozens of visits to hospitals and doctors.
"My whole body was closed," said a Winnipeg woman who has been unable to work since July. "My neck is burning and [it] pain swallow It seems to me that someone is sitting in my chest trying to breathe. "
An advertising machine that manages the $ 1 billion global breast implants sector is used in tastefully lit, forms of aspirational body enhancement, popular recommendations and inspiration from celebrities. – but in many cases, there is little mention of the potential risk, has revealed Toronto Star / CBC Marketplace inquiries in collaboration with the International Investigative Journalists Consortium.
Breast enlargement is the most popular cosmetic surgery in the world, of which 10 million women choose breast implants during the last decade. Most of them have not reported adverse health issues, and some studies indicate a high level of satisfaction. Manufacturers emphasize that over the years there have been many studies that have shown that their products are safe.
But Carruthers is one of the more and more women in Canada who have suffered from health problems that they feel are related to their breast implants. They also believe that they were deceived by surgeons who convinced them that the health problems of the 1990s were focused more than ten years ago.
No cause and effect remain the same as implanting with some of the symptoms described, but research has linked textured implants with rare cancers known as anaplastic large cell lymphoma associated with the breast implant or BIA-ALCL.
Since Monday, ICID has been heard from more than 540 women who responded to the online inquiry for answers to the series of global stories on breast implant health issues. Of the 45 Canadians who responded, women complain of infections, hair loss, inflammation of the body, muscle weakness, shortness of breath, neurological problems, thoughts of suicide and implantation disruption.
The overview of the 25 websites of plastic surgeons in the Toronto area shows a lot of seductive images, but little detail on the negative results of breast enlargement.
Surrounding visits to three Toronto plastic surgeons from the CBC A market maker – who was considered a potential patient – revealed sales practices, some of which were called "very problematic" by leading medical ethics experts.
At age 23, dissatisfied with her body image, Carruthers came up with $ 6,300 – funded with credit lines – for breast augmentation.
It seemed safe and easy. She said she had been little talked about medical risks that go beyond standard alerts related to an operation.
"It seems to have looked like a hairstyle," she said. "He told me that there were only a few cosmetic risks he could remove by touching the procedure if something went wrong."
Nikki Carruthers explains why she initially decided to get breast implants:
The news on the plastic surgery sites she visited was a promise of full trust and perfection.
Anyone worried about his new body condition was soon threatened by health problems, Carruthers, who had implant surgery in 2013, said.
Only over a year later she had another surgery to relieve her chest pain. The implants were grown up and fallen too low in the chest.
Although each separate medical procedure is informed of the consent, the provincial guardian or provincial doctors have not been actively A principle that is designed to ensure that patients are fully aware of the possible outcomes.
There are no standard script plastic surgeons to inform patients about the risks. Each doctor has his or her own approach.
"You must understand"
When The market maker asked about the recovery in three of his clinics, with responses ranging from 24 hours to six weeks.
"We can take you to dinner at night after surgery, we can take you to the beach the next day," said Dr. Mahmood Kara.
When Cora was asked to explain the technique, War replied: "You do not have to understand, just have to know that I can do it, and I've done it for thousands of patients."
The University of Toronto, biochemist Kerry Bowman, claims that the answer does not provide the understanding needed for the patient to have informed consent.
"That worries me because you have to understand," Bowman said. "Ethically and lawfully … you must be able to have patients and they must fully understand and understand all the risks."
The presentation of medical risks associated with breast implants is also of concern.
In the course of the consultation, the War describes what he calls the common surgical risks, such as bleeding, infection, and wounds around the implant, known as capsule contraction.
But on its website, War it's called the "myth" that implants leak in the body if they have broken.
Jan Willem Cohen, director of rheumatology at the University of Alberta School of Medicine, and co-author of several studies detailing the connections between breast implants and autoimmune diseases, say that research is challenging the tips.
"There are many publications that show the release of silicon with new implants," he said.
A list of implant risks The US Food and Drug Administration also notes that the silicone gel from rashes can be fired from the breast.
The war abandoned repeated interview requests.
Consent forms are hard to get
Plastic surgeon Dr. Martin Jugenburg Clinic, known on his website as Dr. 6ix, the journalist requested a copy of the consent form describing the procedures, surgical risks and postoperative instructions that she should sign before making a decision and providing a $ 2,000 deposit to reserve an operation.
"I do not think that for some reason I am allowed to do so," said the clinic nurse, even though she later provided her consent form.
"I'm surprised that there's so much going back to getting matching forms," Bowman said after reviewing. Marketplace hidden camera footage. "I think that a request for payment in advance is a very problematic ethical point of view."
Jugenburg's written response said his clinic does not require patients to pay to view or receive consent forms.
"This was not clear on your researcher's visit, and thanks to your feedback, I made sure that there would be no confusion in the future."
The third Toronto Clinic visited Marketplace, Dr. Sons Rice spent time describing the implant surgery itself. His sister gave her a long form of consent and told the manufacturer that she would need to take her home and read, and then contact the clinic if she had any questions or concerns.
E-mail to Rice said: "I want to ensure that all patients fully understand the risks associated with the surgical procedure. I offer the opportunity to discuss the consent form after review, so that any additional questions can be asked before the surgery. Patients deserve time to evaluate and question the consent. before approving. "
Bowman believes that it is important for patients to decide on the importance of rethinking the decision they make, although physicians do not have a deadline set out in college guidelines.
The market maker was offered a number of available surgical days in the three clinics visited: 24 hours after the consultation, four days later and a few weeks later.
Photos before and after
Most plastic surgeons websites contain reviews and pre-and post-images that seem to violate provincial laws and the Ontario Physicians and Surgeons Policy.
"If earlier, we have been warned about a photo before and after, we have considered that these are ratings that are contrary to the regulation," said college spokeswoman Shae Greenfield, noting that the regulator had punished the doctor for it.
Last year, the College warned the Kara about using magazine advertising before and after photographs.
"Given his repeat offending advertising policy and regulation, [college complaints’] The committee was not satisfied that he would change his behavior without further guidance, "said the decision.
But today, on his website, there are more than 260 photos of plastic surgical procedures before and after.
Jugenburg is currently faced with disciplinary proceedings at a college claiming that he committed professional misconduct in advertising methods, including allowing the film crew to undergo a surgical procedure without the consent of the patient, making "misuse" of his images and sending "before and after her operative pictures of his social media accounts without her consent, "along with" her pressure to follow his social media and promote their accounts. "
Jugenburg's written response said that the allegations were "denied and defended".
He wrote that "pre and post" photographs are "widespread", and these images provide "essential information to the public, as patients are increasingly conducting their research on the Internet, demanding more transparency … and more self-government decision-making capabilities."
TheThe Jugenburg website currently has over 250 pre-and post-illustrations of various plastic surgery procedures.
Some plastic surgeons avoid placement before and after pictures.
Toronto Plastic Surgeon Dr. Leila Kasraks, on her website, explains why she does not: "Given the Ontario Doctors and Doctors Board's advertising regulations imposed on all Ontario doctors, we can not show photos and reviews to our patients."
Choosing an expert
Last September, Nikki Carruthers came to the third breast surgery. This time, they erased her implants, although she had never had a clear diagnosis that linked her symptoms with implants.
When they came out, it turned out that the right implant was a spasm, and both implants had capsule contractions, according to an analysis of removed implants, Pierre Blais, a former health advisor in Canada and a chemist who now runs an Ottawa company testing devices.
"This type of breakdown is widespread and indicates material fatigue," says his report. "This is not the result of injuries or accidental loss."
Interview Blais said Carruthers had a good breakthrough implants, "split into four", is unlikely to be a one-off.
"When looking at the user manual for such a product … it says there may be a breakthrough," said Blais. "It's not really right. They should say that there will be a break – It depends on how long you have it. "
Carruthers said Blais's conclusions were an excuse. "My instincts were correct. I was not insane."
Her expertise, Carruthers, said that the liver tumor had shrunk. But she has not yet returned to work due to pain and fatigue, cognitive impairment, tremors and autoimmune symptoms.
"I can only imagine how many women are currently there … not knowing what has happened, feeling hopeless and crazy," she said. "Everything causes me to hurt me every time I think about it."