PIP implants: the guide the guidance never gave

Industrial silicone in a medical device.

Poly Implant Prothèse substituted non-medical-grade silicone in its implants, with rupture rates far above legitimate devices. The UK response settled on a minimum: no mandated routine removal for intact, symptom-free implants; support for removal where implants failed or anxiety warranted it. The decision — and its costs — were left with the women.

Fifteen years on, time has changed the question. Any remaining PIP is now an old implant of a discredited make: the realistic choice is no longer 'remove or not' but 'planned exchange on your terms, or unplanned surgery on the implant's terms.'

• Planned exchange — PIPs and capsule out as indicated, current-generation CE-marked implants in. One operation, your schedule.
• Explant without replacement — closing the chapter entirely, with or without a lift by tissue.
• Informed surveillance — legitimate only with confirmed-intact implants, scheduled imaging, and honesty that you're monitoring toward an eventual operation anyway.
• Not sure they're PIPs? Era, clinic and imaging usually settle it — missing records block nothing.