McGhan Cohesive Silicone Gel Study Information
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Breast Implants
McGhan Cohesil 410 Silicone Gel Breast Implant Study |
McGhan Style 410 Silicone Gel Breast Implant Study
The following information is the Informed
Consent that patients received when they were
entered into the McGhan Style 410 Cohesive
Silicone Breast Implant Study for silicone
breast implants. As you can see, women are much
more informed regarding the risks and benefits
of breast implants. The breast implant study
information provided here is very thorough, and
informative.
Your surgeon and McGhan Medical Corporation (McGhan
Medical), the manufacturer of silicone-filled
breast implants, are inviting you to participate
in the McGhan Medical Corporation Style 410
Silicone-Filled Breast Implant Clinical Study.
This Patient Informed Consent gives you the
information about your participation in this
study. Please read this information carefully
and ask your plastic surgeon for clarification
on medical terms or any other issues or concerns
you may have before signing this form. Your
signature verifies that you have been given an
opportunity to read all of the information in
the consent and that you have received a copy of
this form.
McGhan Medical Style 410 Silicone-Filled Breast
Implants will be used in your surgery. To
receive these silicone-filled breast implants
and participate in the McGhan Medical
Corporation Style 410 Silicone-Filled Breast
Implant clinical Study, you must:
- be a female 18 years of age or older
- have a condition appropriate for breast
augmentation, reconstruction, or revision
- have adequate tissue available to cover
the implant(s)
- be willing to sign the Informed Consent
document which gives you information about
your breast implants and confirms your
commitment to follow study requirements and
acceptance of the potential risks involved.
You will also be asked to have a magnetic resonance imaging procedure (MRI) performed serially at 1, 3, 5, 7, and 9 years post-implantation and immediately prior to explantation.
A. Purpose and Background
The Food and Drug Administration (FDA) has
issued a guidance document requiring that
clinical studies be conducted to establish the
safety and efficacy of silicone-filled breast
implants ("Guidance on Preclinical and Clinical
Data and Labeling for Breast Prostheses",
October 5, 1999. The McGhan Medical Style 410
Silicone-Filled Breast Implant is an
experimental device that is available to
patients who participate in this clinical study.
This study is designed to collect 10 year data
on the safety and effectiveness of McGhan
Medical Style 410 Silicone-Filled Breast
Implants. A total of 940 patients will be
enrolled into the study (approximately 500
augmentation patients, 200 reconstruction
patients, and 200 revision patients). A subset
of patients participating in this study will
undergo serial MRI screenings throughout the
duration of the study. The purpose of these
MRI's is to determine the occurrence of
asymptomatic or silent rupture, that is, implant
rupture that exists with no noticeable symptoms
to the patient.
B. Device Description
The Style 410 implant is constructed of an
outer silicone elastomer envelope, featuring a
textured surface, with a cohesive gel fill and
shaped design.
C. Procedures
1. You will talk about your procedure and
participation in this study with your surgeon in
advance and you should take sufficient time to
consider your decision.
2. If you agree to participate in this
study, you will first have to be examined to
determine if you are a good candidate and if you
are eligible.
3. Description of Operation: The
operation will be performed by a surgeon using
accepted standards of practice. The operation
may be performed in the physician's office, in a
hospital operating room, or in an outpatient
surgical center. Hospitalization may or may not
be required. Your surgeon will explain the
particular type of implant that will be used,
how and where it will be placed, and the type of
anesthesia to be used. He/she will also give you
an overall description of the operation. This
may not be a one time operation. Further
procedures involving management of complications
may be needed.
4. Surgical Consent: In addition to this
Informed Consent, you may be asked to sign a
surgical consent form which addresses specific
risks of the surgical procedure and risks of
anesthesia.
5. Additional Follow-Up Visits / Extra
Appointments with your Surgeon: In addition
to normal post-operative appointments with your
surgeon, there will be additional appointments
which are required as part of the research. Your
participation in the research will be for 10
years. The study schedule requires follow-up
visits at 0-4 weeks, 6 months, 1, 2, 3, 4, 5, 6,
7, 8, 9, and 10 years after your surgery. each
visit will take about 30-60 minutes. If you have
all of your study devices removed without
replacement (either with a study or a non-study
device) you will continue to be followed via
telephone according to the same study schedule
in order to obtain data on local adverse events.
If you subsequently have a replacement with a
study device, you will resume follow-up via an
office visit. You are making a commitment to
continue in the study for a full ten years and
to complete all of the required follow-up visits
within the time frame indicated. It is extremely
important that you adhere to this follow-up
schedule. If you move within the 10 years,
arrangements will be made with your surgeon for
follow-up with someone in your area. Refer to
the incentive payment section for specific
target periods in which each visit should be
scheduled.
6. Quality of Life Questionnaire: All
augmentation and reconstruction study
participants are required to fill out a
confidential quality of life questionnaire (Form
QL). This questionnaire must be completed during
your office visit. This questionnaire will be
completed prior to primary breast implant
surgery and at the 1 and 2 year follow up
intervals. These forms have been developed to
assess why women choose to have implant surgery
and how having implants affects their quality of
life and self-perception. This questionnaire is
confidential and at no point is it evaluated on
an individual basis, nor is it intended for use
as a screening or counseling tool. This form
should be completed during your scheduled office
visit. Patients who are being followed by
telephone due to explant of all devices will
complete this questionnaire via mail. You are
advised o discuss with your surgeon any
questions or concerns that you may have with
this questionnaire.
7. Connective Tissue Disease Screening:
The relationship, if any, between implants and
the development of connective tissue disease (CTD)
has not been established. The FDA has
recommended that manufacturers of breast
implants obtain information on patients' signs,
symptoms and diagnoses of connective tissue
disease. All study participants are required to
fill out an Activities and Lifestyle Index (Form
A&L) at periodic intervals. This form has been
designed to follow signs and symptoms of
connective tissue disease. You will complete the
Activities and Lifestyle Index before primary
implant surgery and at the 1, 2, 4, 6, 8, and 10
year follow-up visits. This form should be
completed during your scheduled office visit.
Your surgeon will review the completed
questionnaire with you. He/she will let you know
whether or not you should consider visiting a
rheumatologist for further evaluation.
In addition, if you indicate that you have a
connective tissue disease, the doctor who
diagnosed your condition or your attending
doctor will need to be contacted to provide
confirmation of the diagnosis. Your surgeon will
contact your diagnosing/attending physician for
information regarding any connective tissue
disease you may have.
8. Photographs: Photographs of your
breast/chest area will be taken by your surgeon
or his/her staff prior to surgery and one year
after surgery. These photos will remain
confidential and may be viewed by your surgeon,
office staff, and McGhan Medical personnel or
representatives of McGhan Medical. The FDA also
may have access to these photos, as with other
study records.
9. Magnetic Resonance Imaging (MRI): You
will be asked to undergo a magnetic resonance
imaging procedure (MRI) serially at 1, 3, 5, 7,
and 9 years post-implantation to evaluate the
occurrence of asymptomatic rupture. If you have
all of your original study implants removed
(with or without replacement), you are no longer
eligible to participate in the serial MRI
portion of this study.
Additionally, if you are scheduled for
explantation of your study implants for any
reason, you will be asked to obtain an MRI
immediately prior to explant surgery. The
purpose of the pre-explant MRI is to determine
the effectiveness of MRI for detecting possible
implant rupture.
At any time of study enrollment, you will be
evaluated for eligibility and willingness to
undergo MRI. You will be excluded from the MRI
portion of the study if you have any metal
devices or metal implanted or a past history of
severe claustrophobia. Please inform your
surgeon if you may be ineligible to participate
in the MRI portion of the study. He/she will let
you know if you are eligible.
MRI is a medical diagnostic technique that has
been used to determine if an implant has
ruptured. However, it is not a routine procedure
for determining whether a breast implant is
ruptured and may not always be able to detect a
rupture. MRI uses no x-rays and the magnetic
fields MRI uses are not known to be harmful;
that is, though the use of magnetic fields is
not thought to be harmful, short- and long-term
side effects are unknown.
MRI involves a painless scan. For the MRI scan,
due to the magnetic field, you will be required
to remove all metal objects (e.g., jewelry, eye
glasses) prior to scanning. A surface coil will
be attached to the breast/chest area. Scanning
involves being placed on a scanning tunnel, open
at both ends. You will be required to stay still
during the scan. Total scanning usually ranges
from 30-90 minutes. If you are uncomfortable
being in a small, enclosed place, a physician
may give you a sedative. In such cases, someone
should attend the MRI with you to assist you.
Please discuss any questions about MRI with your
surgeon. You will be required to attend an MRI
clinic in which the appropriate MRI technique
will be utilized. At the MRI facility where the
MRI will be performed, you should also be
informed about MRI and sign an informed consent.
The local MRI facility will also evaluate you to
determine if you are eligible for MRI.
Your surgeon's office will assist you in
scheduling the MRI.
In order to allow for an unbiased evaluation of
your MRI, please do not indicate to the MRI
staff performing your MRI screening whether you
or your surgeon suspect that your implant(s) may
be ruptured. Your results from the local MRI
facility will be forwarded to your surgeon.
Additionally, the MRI images on disk, without
the report, will be sent to a second MRI
reviewer (MRI Central Reviewer), who will review
all MRI results obtained in the study. The MRI
Central Reviewer will perform an independent
evaluation of your MRI; that is, the results
from the local facility will not be known to the
MRI Central Reviewer. The MRI Central Reviewer
will provide a detailed report to your surgeon
and McGhan Medical. Your surgeon will review the
findings of both the local facility and Central
Reviewer reports and consult with you as to the
appropriate treatment, if necessary.
10. Removed Implants: If during the
course of the study both of your implants (or
one if implanted on one side only) are removed
and replaced with a non-study device, you will
be discontinued from this study. If you have
your study devices removed without replacement,
either by a study or non-study device (i.e., you
no longer have any breast implants), you will
continue to be followed via telephone in order
to obtain data on local adverse events.
11. Analysis of Removed Implants: If
there is a problem resulting in a medical need
to remove your breast implants, McGhan Medical
and the FDA believe there is a scientific
benefit to testing an explanted implant Should
McGhan Medical perform an evaluation of the
removed implants, the testing could alter or
destroy the implant.
12. Implant Identification: After your
surgery, your surgeon will provide you with
identification information regarding the type of
implant you have. This information should be
kept with your important papers for future
reference.
13. Second Opinions: If any problems or
complications occur, you may be asked for with
to obtain a second opinion. You have the right
to consult with a physician of your choice.
D. Benefits of Breast Implants
The major effect of breast implants is to
enhance or restore the appearance of a woman's
breasts. Breast implant surgery may benefit you
by providing a successful breast reconstruction
or augmentation. There may be psychological
benefits to having breast reconstruction or
augmentation with silicone-filled implants. Each
individual woman has her own private sense of
how she wishes to look and whether she wishes to
go through surgery o achieve this appearance.
Ongoing studies will help evaluate whether
breast implants improve a woman's quality of
life.
Participating in the study also may benefit
other women in future by providing scientific
information about breast implants.
E. Risks
1. Risks, Complications, and Discomforts of
the Operation : Breast surgery requires an
incision into the breast under anesthesia. As
with any surgical procedure, there are risks,
such as infection, delayed wound healing,
hematoma formation, seroma, bleeding, and
possible reactions from anesthesia. These
complications are uncommon. Surgical risks may
include but are not limited to:
a. Infection: An infection can result
from any surgery and produce swelling,
tenderness, pain, and fever. Almost all
infections appear within a few days of the
operation but on rare occasions may appear at
any time after your surgery. If you get a
serious infection which does not go away with
antibiotics, your implants may need to be
removed.
b. Hematomas / Seromas: Hematoma is a
collection of blood inside the body in and round
where the incision is made. Seroma is an
accumulation of fluid around the implant.
Post-operative hematoma and seroma may
contribute to infection and/or capsular
contracture. Any post-operative evacuation of
hematoma or seroma must be conducted with care
to avoid damage to the implant.
c. Toxic Shock Syndrome (TSS): TSS is a
rare but serious risk from any surgical
procedure. Symptoms include, but are not limited
to, sudden fever (102ยบ or above), vomiting,
diarrhea, fainting, dizziness, and/or
sunburn-like rash. If TSS symptoms occur, seek
medical attention immediately.
d. Delayed Wound Healing: Your physical
condition and overall health at the time of your
surgery can influence how you heal. Other
factors that may interfere with the ability of a
wound to heal correctly are chronic illness,
smoking, and certain medications that affect
tissue or blood. Any incision in the skin will
leave a scar. Surgical techniques under most
circumstances can minimize, though not
eliminate, scarring.
e. Bleeding or Anesthesia Reactions:
These complications are uncommon. Through
screening before surgery by the surgeon and
anesthesiologist greatly minimize these risk
factors associated with surgery.
f. Iatrogenic Injury: Iatrogenic injury
is an injury to you, or your implants, caused by
your surgeon or by medical procedures performed
on you. Any surgical procedure involves the
potential for accidental injury to you or your
breast implants. Any invasive surgical procedure
involving general anesthesia also carries
certain risk.
2. Risks, Complications, and Discomforts
of the Breast Implants :
Breast implants have certain specific risks
and complications which may include:
a. Capsular Contracture: Scar tissue,
referred to as a capsule, typically forms around
the implant. This is a natural response to
having any foreign object implanted in the body.
The scar tissue that forms around the implant
can contract or tighten and squeeze the implant
making it feel firm. This firmness can range
from slight to hard and can cause varying
degrees of discomfort or pain. Radiation therapy
subsequent to breast implant surgery may
increase the risk of capsular contracture.
The scar tissue can be released or removed
altogether by a procedure called Capsulectomy.
Your surgeon may recommend a technique called
Closed Capsulotomy in which he/she will apply
forceful external pressure to the breasts to
"break up" the scar tissue. This technique is
not recommended by the manufacturer. However,
your surgeon may feel this is the best method
for correcting the firmness because, if it
works, it is quick, simple, and avoids surgery,
although it may be painful. If your surgeon uses
this technique, several complications may occur,
including bleeding and displacement of the
implant which may result in asymmetry,
distortion, and breakage of the implant.
Your surgeon should explain the possible
complications as well as help you determine your
choice for correcting capsular contracture.
b. Calcium Deposits: Any surgery or
injury to the breast can produce small spots of
calcium in the breast tissue which can e seen on
X-rays (mammography). These deposits may not
occur until years after implant surgery. They
are benign (non-cancerous) and cause no problems
but must be differentiated from the calcium that
is often seen in breast cancers. An expert
radiologist can usually tell a benign calcium
spot from a malignant one but occasionally a
biopsy may be necessary to be absolutely sure.
Some patients may develop a thin layer of
calcium in the scar capsule that surrounds the
implant. This is almost always associated with
capsular contracture but otherwise causes no
problem.
c. Rupture: Breast implants are not
lifetime devices and cannot be expected to last
forever. Some implants deflate or rupture in the
first few months after being implanted and some
deflate after several years; others are intact
10 or more years after surgery.
When silicone gel-filled implants rupture, some
women may notice a decreased breast size,
nodules (hard knots), uneven appearance of the
breasts, pain or tenderness, tingling, swelling,
numbness, burning, or changes in sensation.
Other women may unknowingly experience a rupture
without any symptoms (i.e. "silent rupture").
Magnetic resonance imaging (MRI) with equipment
specifically designed for imaging the breast may
be used for evaluating patients with suspected
rupture or leaking of their silicone gel-filled
implant.
Silicone gel which escapes the fibrotic capsule
surrounding the implant may migrate away from
the breast. The free silicone may cause lumps
called granulomas to form in the breast or other
tissues where the silicone has migrated, such as
the chest wall, armpit, arm, or abdomen.
Plastic surgeons usually recommend removal of
the implant if it has ruptured, even if the
silicone is still enclosed within the scar
tissue capsule, because the silicone gel may
eventually leak into surrounding tissues. If you
are considering the removal of an implant and
the implantation of another one, be sure to
discuss the benefits and risks with your doctor.
FDA completed a retrospective study on rupture
of silicone gel-filled breast implants. This
study was performed in Birmingham, Alabama and
included women who had their first breast
implant before 1988. Women with silicone
gel-filled breast implants had a MRI examination
of their breasts to determine the status of
their current breast implants.
The 344 women who received a MRI examination had
a total of 687 implants. Of the 687 implants in
the study, at least two of the three study
radiologists agreed that 378 implants were
ruptured (55%). This means that 69% of the 344
women had at least one ruptured implant. Of the
344 women, 73 (21%) had extracapsular silicone
gel in one or both breasts. Factors that were
associated with the rupture included increasing
age of the implant, the implant manufacturer,
and submuscular rather than subglandular
location of the implant. A summary of the
findings of this study is also available on the
FDA's website at:
http://www.fda.gov/cdrh/breastimplants/studies/biinterview.pdf
http://www.fda.gov/cdrh/breastimplants/studies/birupture.pdf
Robinson et al. studied 300 women who had
their implants for 1 to 25 years and had them
removed for a variety of reasons. Visible signs
of rupture in 51% of the women studied were
found. Severe silicone leakage (silicone outside
the implant without visible tears or holes) was
seen in another 20%. Robinson et al. also noted
that the chance of rupture increases as the
implant ages.
Other studies indicate that silicone may escape
the capsule in 11-23% of rupture cases.
d. Silicone diffusion: Some silicone
may also diffuse or "bleed" through the shell of
the implant into the fibrotic capsule
surrounding the implant. See above for
discussion of silicone gel which then escapes
the fibrotic capsule.
e. Complications with healing: Some
potential complications with healing are
extrusion, skin erosion, and necrosis. Extrusion
occurs when the implant(s) pushes through the
incision site or skin. This is rare but can
occur. Skin erosion is the destruction of tissue
that can have either a physical cause (e.g., the
implant) or an inflammatory cause (e.g.,
infection). Necrosis is tissue death which can
be caused by a variety of reasons associated
with your surgery or your physical condition
such as insufficient blood supply, radiation,
and trauma.
f. Revision Surgery: Your implant(s) is
not a lifetime device. Revision surgery,
consisting of removal and replacement of your
implant(s), may be required at any time. Medical
management of adverse reactions may include
subsequent surgeries, and possibly, revision
surgery. Revision surgery may also be indicated
to achieve satisfaction with cosmetic results.
Second opinion: If any problems or complications
occur, you may wish to obtain a second opinion.
You have the right to consult a physician of
your choice. However, you will be financially
responsible for any second opinion.
g. Breast Tissue Atrophy / Chest Wall
Deformity: Removal of implant(s) without
replacement may cause tissue atrophy. In the
event of explantation (permanent implant
removal), the tissue that originally surrounded
the implant may over time shrink and diminish.
It also has been reported in rare cases that the
chest wall at the site of the implant may appear
deformed upon explantation (removal of implant).
h. Changes in Nipple and Breast Sensation:
Any surgery on the breast, including a biopsy or
breast implant surgery, can result in increased
or decreased sensation of the breast and/or the
nipple. This change can vary in degree and may
be temporary or permanent. It may affect sexual
response or comfort while nursing.
i. Interference with Mammography: An
implant can interfere with the detection of
early breast cancer because it may "hide"
suspicious lesions in the breast during an x-ray
exam. It is especially important for women who
are at high risk for developing breast cancer to
consider this before having implants. The
earlier cancer is detected, the better the
chance for a cure. You should discus with your
physician the potential risks and benefits of
pre-operative and post-operative mammography as
baselines for future reference.
Since the breast is compressed during
mammography, it is possible, but rare, for an
implant to rupture. These problems can be
reduced, but not eliminated, by making sure the
mammography facility is accredited by the
American College of Radiology (ACR) and asking
if the personnel at the facility are experienced
in performing mammography on women with
implants. The telephone number for the American
College of Radiology is 800-227-6440. The ACR
will be able to give listings of accredited
facilities by state. Please note the
accreditation does not imply expertise in
performing mammography on women with implants.
Before the mammography exam, you should tell the
technologist that you have breast implants. The
technologist should take special care when
compressing the breast to avoid implant rupture.
Also, an experienced technologist should know
how to push the implant away from the breast
tissue to get the best possible views of the
tissue. Even when this special technique is
used, some breast tissue may be missed in X-ray.
Also, women with implants are subject to
additional radiation and higher costs because
more x-ray views are needed.
The small amount of additional radiation should
not deter you from having mammograms when
needed. The risk of a missed cancer is far
greater than the risk associated with a slight
amount of extra x-ray exposure.
j. Cosmetic Complications: You may not be
satisfied with the appearance of your breast
implants. Incorrect implant size, inappropriate
scar location or appearance, and misplacement of
implants may interfere with a satisfactory
appearance. Asymmetry (unequal breast size or
shape) may occur. The implanted breast may sag
or droop (ptosis) over time, much like a natural
breast. Very rarely the implant may change
position or break through the skin, particularly
if you have very thin breast tissue covering it.
You may be able to feel or see the breast
implant. You also may feel or see wrinkles in
the implant through your skin. Although these
complications are not dangerous, you should be
aware of these possibilities when considering
breast implant operation as they can detract
from the quality of the result.
k. Breast Feeding: Breast implants may
affect your ability to produce milk for breast
feeding. At this time it is not known if a small
amount of silicone may diffuse (pass through)
from the silicone-filled breast implant silicone
shell and may find its way into breast milk. If
this occurs, it is not known what effect it may
have on the nursing infant. Although there are
no current methods for detecting silicone levels
in breast milk, a study measuring silicon (one
component in silicone) levels did not indicate
higher levels in breast milk from women with
silicone-filled gel implant when compared to
women without implants. Also breast implants
will not prevent your breast from sagging after
pregnancy.
With respect to the ability to successfully
breast feed after breast implantation, one study
reported up to 64% of women with implants who
were unable to breast feed compared to 7%
without implants. The periareolar (around the
nipple) incision site may significantly reduce
the ability to successfully breastfeed.
l. Granulomas: These are non-cancerous lumps that can form when certain body cells surround foreign material, such as silicone. Like any lump, a granuloma should be further evaluated to distinguish it from a lump that might be cancerous and may require a biopsy.
3. Unknown Risks: In addition to
these known risks, there are unanswered
questions about silicone-filled breast implants.
Both rupture and "silicone-bleed" may result in
the silicone going to other parts of the body.
Some medical complications which may occur as a
result of these devices are unknown; however,
there may be long-term effects which include:
a. connective Tissue Disease (CTD): There
has been continuing concern that there may be a
relationship between breast implants and
connective tissue disease. These diseases
include autoimmune illnesses such as lupus,
scleroderma, and rheumatoid arthritis, as well
as disorders such as fibromyalgia and chronic
fatigue syndrome. Some women with breast
implants have experienced these diseases, as
well as a variety of symptoms that could be
related to the immune system. These symptoms
include pain and swelling of joints, tightness,
redness or swelling of the skin, swollen glands
or lymph nodes, unusual and unexplained fatigue,
swelling of the hands and feed, excessive hair
loss, memory problems, headaches, and muscle
weakness or burning. However, symptoms such as
these may be present in persons without
connective tissue disease, or without breast
implants. So it is unclear at this time whether
the signs and symptoms experienced by these
women are related to their implants.
Several human studies have been completed
recently, which provide substantial, but not
complete, information about any possible link
between breast implants and immune-related
disorders. These studies provide reassurance
that the risk of the developing a connective
tissue disease due to a breast implant is not
high. Taken together, these studies tell us that
the vast majority of women will not develop
defined immune-related disorders from the
implants. None of the studies described above
can completely resolve the question of whether
silicone-filled breast implants increase the
risk of connective tissue disease or related
disorders. Because of limitations in study
design or study size, none of them have been
able to rule out the possibility that the
implants can cause immune-related disorders in a
small subset of women who have them. Second,
since these studies were largely designed to
find out whether women with breast implants had
certain well-defined immune-related diseases,
one cannot exclude the possibility that some
women with breast implants might develop other
signs and symptoms related to the immune system
that do not conform to "classic disease
descriptions.
b. Cancer: At this time there is no
scientific evidence that silicone-filled breast
implants can increase the risk of cancer in
women. However, this possibility cannot be
completely ruled out. Average follow-up time of
completed studies in women have been too short
to be fully conclusive.
c. Birth Defects: Preliminary animal
studies show no evidence that birth defects are
caused by breast implants. However, to rule out
that possibility for humans, further scientific
studies are necessary to show whether or not
breast implants are associated with birth
defects.
d. Neurological Symptoms: There have been
some reports of patients experiencing
neurological symptoms as various times after
breast implantation. Some of the complications
have involved difficulties with vision,
sensation, memory/coordination, muscle strength,
walking and balance. However, there is no
current scientific evidence that links breast
implants to these types of neurological
symptoms.
Your doctor should discuss with you any
additional information about the risks of
silicone-filled breast implants and your
surgical procedure. You are also encouraged to
read the Package Insert which your doctor will
provide to you, upon request.
F. Alternative Procedures
There are several alternative procedures to
breast augmentation or reconstruction with
silicone-filled breast implants. These include
having nothing done or wearing an external
prosthesis inside your bassiere (no surgery
required). Breasts can be made by transferring
fatty tissues from other parts of the body such
as the stomach, buttocks, or back (flat
procedure).
For many women saline-filled breast implants are
an alternative. You also may choose to have your
silicone-filled breast implant procedure with
another physician who is using another
manufacturer's implant. Your surgeon should
discuss these alternatives with you.
G. Cost
1. Costs: This study may involve one or more
visits to a rheumatologist or other specialist.
There may be an extra charge for these visits.
All costs incurred in this study are between you
and your physician (with the exception that
McGhan Medical will pay for MRI procedures
performed as a part of this study). Costs may be
incurred due to any additional procedures or
visits to another specialist that may be
required for the operation. Your operation and
associated costs may or ay not be reimbursed
through insurance.
2. Insurance: Breast reconstruction using
silicone-filled breast implants has been covered
under existing insurance policies. There are no
known reasons why existing coverage policies
should not continue. Elective cosmetic
procedures, such as breast augmentation, are
generally not covered under most insurance
policies. If is your responsibility, with your
doctor's help, to contact your insurance company
to determine what coverage, if any, is available
for this procedure.
3. Compensation for Injury: You may be
financially responsible for costs incurred due
to any additional procedures associated with
your breast implants(s), including any revision
surgery that may be necessary. Compensation for
physical injuries, complications, or medical
treatment from your participation in this study
is not available from McGhan Medical. If a
problem occurs, medical treatment will continue
to be available. Your surgeon should advise you
if you experience any complications while you
are in this study.
4. McGhan Medical Confidence Plus T Program:
Through the McGhan Medical ConfidencePlus T
Program McGhan Medical offers limited financial
assistance to cover certain revision expenses in
the event of a rupture and it guarantees
lifetime implant replacement. Other than what is
described in the program, compensation for
physical injuries, complications, or medical
treatment from your participation in this study
is not available from McGhan Medical. If a
problem occurs, you should see your surgeon.
5. Legal Risks: If your implant needs to
be removed, the FDA encourages the implant to be
returned to McGhan Medical for evaluation. This
could have implications in any legal actions
involving your implant.
6. Incentive Program: McGhan Medical is
offering an incentive program (see incentive
table below) to all participants in this
important research study. Your physician will
also be receiving an incentive throughout and
study period for participating in this clinical
study as an investigator.
ENROLLMENT SURGERY AND FOLLOW-UP VISIT
PAYMENTS
| Treatment / Follow-up Visit | Target Time Frame for Follow-up Visit (from the date of enrollment/primary implant surgery) |
Form 6 (completed by site) |
Form QL (completed by patient at time of visit) |
Form A&L (completed by patient at site) |
Other Forms (completed by patient and site) |
Payments to Patients | Payments to Investigational Sites |
| Enrollment / Primary Implant Surgery | - | - |
|
|
Informed consent, Form 1, 2, 5 | $100 | $100 |
| 0-4 Weeks | 0-4 weeks |
|
- | - | As Needed | $100 | $50 |
| 6 months | 6-8 months |
|
- | - | As Needed | $100 | $50 |
| 1 year | 12-24 months |
|
|
|
As Needed | $100 | $50 |
| 2 year | 24-26 months |
|
|
|
As Needed | $100 | $50 |
| 3 year | 36-38 months |
|
|
|
As Needed | $150 | $50 |
| 4 year | 48-50 months |
|
|
|
As Needed | $150 | $50 |
| 5 year | 60-62 months |
|
|
|
As Needed | $150 | $50 |
| 6 year | 72-74 months |
|
|
|
As Needed | $150 | $50 |
| 7 year | 84-86 months |
|
|
|
As Needed | $150 | $50 |
| 8 year | 96-98 months |
|
|
|
As Needed | $150 | $50 |
| 9 year | 108-110 months |
|
|
|
As Needed | $150 | $50 |
| 10 year | 120-122 months |
|
|
|
As Needed | $200 | 100 |
| Post-Explant Telephone Follow-Up | Within target time frame of required visit (above) | - |
(completed via mail for 1 and 2 year follow-ups, if applicable) |
- | Form 17 (completed by site) | $50 | $50 |
MRI INCENTIVE PAYMENTS
Incentive payments to patients and
investigational sites participating in the
serial MRI portion of the protocol will be
processed after all applicable forms are
received at McGhan Medical, and after
verification that the MRI was completed within
the target time frame.
| Follow-up Visit | Target Time Frame for Follow-up Visit (from date of enrollment / primary implant surgery) | Target Time Frame for MRI (from date of follow-up visit) | Form MRI - 12 Central Reviewer (completed by site) | Cost of MRI (paid by McGhan Medical Corp.) | Payments to Patients | Payments to Investigational Sites |
| 1 year | 12-14 months | Within 1 month after visit |
|
|
TBD | $50 |
| 3 year | 36-38 months | Within 1 month after visit |
|
|
TBD | $50 |
| 5 year | 60-62 months | Within 1 month after visit |
|
|
TBD | $50 |
| 7 year | 84-86 months | Within 1 month after visit |
|
|
TBD | $50 |
| 9 year | 108-110 months | Within 1 month after visit |
|
|
TBD | $50 |
Please Note: If you have all of your original
study implants removed (with or without
replacement), you are no longer eligible to
participate in the serial MRI portion of this
study.
PRE-EXPLANT MRI INCENTIVE PAYMENT
Incentive payments to patients and
investigational sites for completion of a pre-explant
MRI will be processed after all applicable forms
are received at McGhan Medical.
| Requirement | Target Time Frame for MRI | Form 16 Pre-Explantation MRI Authorization Form | Form MRI - 12 Central Reviewer (completed by Central Reviewer) | Form MRI - 13 MRI Results (completed by site) | Cost of MRI (Paid for by McGhan Medical Corp.) | Payments to Patients | Payments to Investigational Sites |
| Pre-Explant MRI | Before Explantation |
|
|
|
TBD | $200 | $50 |
H. Confidentiality Issues / Patient
Identification
Your confidentiality will be protected as
much as possible throughout this study. You
should understand that the following personnel
and agencies may find it necessary to review
your medical records and study information:
McGhan Medical research personnel or individuals
contracted by McGhan Medical, the FDA or other
regulatory agencies, and the Institutional
Review Board (IRB) of the facility where your
procedure was performed. Your medical records
and study information could also be obtained by
Congress or by a court order. While every effort
will be made to keep your identity confidential,
under certain circumstances this may not be
possible and public disclosure of your surgery
and loss of privacy could occur.
I. Voluntary Participation and Withdrawal
from the Study
Your participation in this study is
voluntary and your decision not to participate
will not result in loss of benefits to which you
are otherwise entitled; however, you will not
receive McGhan Medical Style 410 Silicone-Filled
Breast Implants without being in a McGhan
Medical clinical study. You may drop out at any
time and you will still receive all necessary
medical care. If you move during the course of
the study, you should notify your surgeon. In
order to continue your participation in the
study, with the assistance of your surgeon,
another physician in your area will be located,
if necessary.