At Cosmetex 2015, we had an opportunity to speak with Professor Colin Moore of the Australasian College of Cosmetic Surgery (ACCS) to talk about the newly introduced Australian Breast Implant Registry. Here’s our interview with Professor Moore, and it reiterates why Australia is truly a world leader in this field.
PLASTIC SURGERY HUB: We’re here today talking to Professor Colin Moore who is from the Australasian College Of Cosmetic Surgery (ACCS). And Professor Moore is going to talk to us today about the newly introduced Australian Breast Registry.
So thanks for taking the time to talk to us Professor Moore.
PROFESSOR COLIN MOORE You’re very welcome Trish.
PLASTIC SURGERY HUB: Can you just tell our readers about a little bit about what the breast registry is and why it was introduced in Australia?
PROFESSOR COLIN MOORE Ok, the new Breast Devices Registry is a means of capturing every breast implant that is put into Australian women, and into some overseas Australian women over the next little while so that we can monitor the performance of implants – look for problems hopefully before they get too advanced. Some of you may remember the PIP (Poly Implant Prothese – a French company) crisis of recent times where the PIP manufacturer had used inferior quality silicone, in the manufacture of their implants.. there was leakage in one thing and another. And ACCS was intimately involved with the TGA (Therapeutic Goods Administration) in their investigation of this.
Now, implants have been around a long time. Breast registries in Australia first started in 1998, they were run by the plastic surgeons for the plastic surgeons. They were what we call “opt in” registries and what this meant was; that you had the registry there and if I was the surgeon for what I might like to have this particular patient’s implants in, then I’d put her in, but the next two I might not.
PLASTIC SURGERY HUB: Ok.
PROFESSOR COLIN MOORE So in fact, that registry only collected 4% of known implants in this country. There are a couple of other crises – there was the Dow crisis in the 90s which – and this is the other side of the registry – Dow produced silicone which was found to be the cause of all sorts of strange diseases in women. So Dow Corning was forced in to Chapter 3 bankruptcy by the lawsuits that followed. Had there been an implant registry at that time it would have shown that these particular diseases are no more common in breast implant patients than in the general population at large! So it would have saved Dow Corning’s bacon… so that’s one aspect of the registry.
More recently, as a result of cooperation between Professor Rod Cooter and myself, ASPS (Australian Society of Plastic Surgeons) and ACCS agreed to be part of a new breast devices registry and subsequently the non breast RACS surgeons (Royal Australasian College of Surgeons); that is, surgeons who do breast work but who are not plastic surgeons… they subsequently joined us as well. And then, in collaboration with the Department of Epidemiology and Preventive Medicine at Monash University, it was decided to form what’s called an “opt out” registry. That is, automatically every breast implant that goes in Australia – once this registry is up and running – goes into the registry. The only way it doesn’t go in is if the patient violently objects, and they have to have strong and good solid reasons to object in order to escape being in the registry. And the advantage is that we’ll have every implant – we’ll know when things are going wrong, we can look at all sorts of things. We can look at surgeon performance, institutional performance, what type of implant is performing better than another?
The management committee of this consists of the three clinical groups – ACCS, RACS Plastic and RACS Non-plastic. And then there is a TGA representative, there’s industry representatives, consumer representatives and of course Monash has its University people in charge. And Monash provides the chairperson for this registry so no clinical group has greater sway than another, which is really very important. This is on the point of running. We’ve done a trial series on it and it captured 97% of implants.
PLASTIC SURGERY HUB: Fantastic! So even if it’s just a proportion that’s going to be way enough for studies, or (to see) what’s going on..
PROFESSOR COLIN MOORE Sure, sure, it’s a hell of a lot better than 4%!
PLASTIC SURGERY HUB: Oh that’s great. As far as the consumer goes… why is this good a thing for them?
PROFESSOR COLIN MOORE It’s good thing because it will monitor a number of things. It will monitor things like the texture of the implants. So that over a period of time we’ll be able to watch that performance and be able to provide surgeons with information about particular textures on one hand versus another, which is important information you can pass on to your patients. The most important thing is we’re looking out for large cell capsular lymphoma in the breast which is a malignant condition… very low incidence… but if we can see a trend, even a small trend then we can warn the profession and changes can be made in clinical management. So it’s an ancillary product; it’s another bit of information for surgeons, and it’s very, very helpful for the patient.
PLASTIC SURGERY HUB: Fantastic! And do you know if this happens anywhere else in the world?
PROFESSOR COLIN MOORE Oh yes. It’s interesting. The Yanks have fiddled around with it for a while but they are now looking at forming a North American implant registry. Guess what? Modeled on ours!
PLASTIC SURGERY HUB: Great!
PROFESSOR COLIN MOORE Same thing in the UK. They’re looking at doing it modeled on us. The Dutch has set theirs up… modeled on ours. I know that New Zealand, oh where else… there’s one other country… are also looking at our registry format. So we’re being copied. We’re a world leader.
PLASTIC SURGERY HUB: Fantastic. Well like I always say, we’ve got some of the best surgeons here in Australia… I don’t know why anybody would go anywhere else. So, thank you so much Professor Moore for talking to us today. That’s been really fantastic.
PROFESSOR COLIN MOORE It’s my pleasure, Trish, you’re very welcome.