Surgeons suffer silicone symptoms.

Southland plastic surgeons who specialize in breast augmentation have seen business cut in half by the federal Food and Drug Administration's April 20 ban on silicone gel implants for cosmetic purposes, and the surrounding publicity.

"We are seeing about one-half as many implants as in years previously," said Dr. Dennis Thompson, a board-certified plastic surgeon in Santa Monica and president of the Los Angeles County Society of Plastic Surgeons. "It is too soon to tell whether business is off for good, or whether business will pick up again. I don't know what the future holds."

Thompson's comments are echoed by other local plastic surgeons, who say they are angry about what they see as a largely uncalled-for intrusion into their practices and a media-created hysteria about the risks of silicone.

There are about 200 board-certified plastic surgeons in the Los Angeles area, although other doctors can practice cosmetic cutting. The Southland is generally regarded as the world capital of plastic surgery, and people from all over the globe come here for treatment.

The FDA banned the popular silicone breast implants -- about 2 million American women have had their breasts enlarged with some form of foreign matter -- because some inserts, particularly older models, spring leaks, oozing silicone into the body.

Some believe the silicone gel can then disrupt the body's immune system, although local plastic surgeons are adamant that such fears are ungrounded. Many accuse the FDA of unwarranted moralism.

"They allow the silicone gel for women in reconstructive surgery, but not for women who want to enhance their looks," said Dr. Larry Seifert, a board-certified plastic surgeon near the Cedars-Sinai Hospital in Los Angeles. "FDA staff members have been quoted as saying women who want breast augmentations must have 'Barbie complexes' (a need to appear physically perfect). This is trial by media and junk science."

Local plastic surgeons note that silicone is broadly used in medicine and prosthetic devices, precisely because it is considered to be largely inert inside the human body. Indeed, silicone is used for men as testicular implants (following cancer) and penile implants, uses that are unchallenged, said Thompson.

Furthermore, say doctors, the human body encloses all kinds of silicone implants, including false breasts, in scar tissue. That means the silicone probably cannot escape into the body anyway.

Silicone also lines the insides of syringes, meaning that people who get a lot of injections, such as diabetics, have relatively large amounts of silicone regularly injected into their bloodstreams without incident, said Dr. F. Richard Jones, a board-certified plastic surgeon in Fullerton.

"This is hysteria. All of this panic is ridiculous," said Jones. "You can have problems with breast augmentation, but in 28 years, I have never seen a cancer or an immune problem related to breast augmentation."

Whether it is moralizing or not, the FDA ban is law, and Los Angeles plastic surgeons, like doctors across the country, are now implanting saline artificial breasts for cosmetic purposes. The FDA still allows the silicone gel-filled inserts for reconstructive surgery, or to replace existing gel-filled implants where problems have developed.

The salt-water-filled breast implants are not as realistic and therefore not as popular as the silicone version, said Thompson and other doctors, and thus are less in demand. "The way I explain it is this: It is the difference between a (sandwich-type) baggy filled with water, and one filled with Jell-O," said Thompson.

Most local plastic surgeons do not exclusively specialize in breast enlargements, and so the reduction in business, while a loss, has been muted by diversification. "Oh, before the ban, I probably did one or two (implants) a week," said Seifert. "It is not a technically difficult operation, and I know few board-certified plastic surgeons that do just breast augmentations."

Still, the ban has meant lost bucks for plastic surgeons: A typical augmentation runs $3,000 to $6,000. A doctor who performed two a week last year, and this year does only one, will lose out on about $225,000 in gross income, although the net would be considerably smaller.

But while the U.S. ban on silicone implants has been bad for business locally, it is a boon to overseas plastic surgeons, in countries where the product is legal.

"We hear the orders for silicone breasts are up in Europe," said McGuire, the Santa Monica surgeon. "In fact, Great Britain specifically studied this problem and found there was no reason to ban silicone breast implants. The customers will probably go there."