Complications From Breast Implants

I would like to compliment Erin Marcus on her article regarding breast reconstruction {Women's Health, Jan. 22}. Repair of the breast with flaps of tissue from elsewhere in the body has been a significant advance in plastic surgery over the past 10 years.

However, the accompanying article on silicone implants overlooked a recent study by the American Society of Plastic and Reconstructive Surgeons showing that the majority of women not only were happy with the procedure but also would decide to do it again. The rate of natural scar hardening around the implant is nowhere near 70 percent, but closer to 40 percent. Early evidence indicates that use of textured implants may reduce this rate.

In addition, it is a bit premature to associate silicone breast implants with auto-immune diseases. Problems with the immune system have not been seen in any increased frequency with other silicone-coated or silicone-implantable devices, such as pacemakers and shunt tubing. Most needles used for injection today are lubricated with silicone.

Maryland law requires full disclosure, in pamphlet form, of the risks and potential complications of the use of silicone breast implants. Donald S. Stepita, MD President National Capital Society of Plastic Surgeons Washington

Programs for Post-Polio Patients

The item on local resources for polio survivors {Calendar, Jan. 22} was very helpful, but the explanation given for the cause of post-polio syndrome was misleading. Post-polio syndrome is not believed to be related to the type of treatment patients received during their convalescence.

Medical researchers do not yet know the cause or causes for the new muscle weakness, extreme fatigue and new muscle atrophy being experienced by more than 50 percent of people who had paralytic polio years ago. The most widely held theory is that the new muscle weakness is related to the overuse of polio-damaged nerves in the spinal cord. As these nerves begin to malfunction after 30 to 40 years, the muscles they supply become weaker and, in some cases, smaller.

Many health care providers are not knowledgeable about polio-related health problems, but specialized rehabilitation and support services are now available to help them manage polio-polio symptoms. The National Rehabilitation Hospital's Post-Polio Program evaluates and treats polio survivors and provides information to health care professionals. The Polio Society also will send information to primary-care physicians who treat its members. Lauro Halstead, MD Director National Rehabilitation Hospital Post-Polio Program Jessica Scheer, PhD National Rehabilitation Hospital Research Center Washington

Alarmist Health Ads

In the discussion of alarmist health ads that promote anxiety {Consumer News, Jan. 15}, I agree with the statement by ethicist Daniel Callahan, director of the Hastings Center, that "the very emphasis on health prevention requires raising the level of anxiety enough so people will feel motivated to go in and get tested."

As a health care marketer, I believe that the goals of a successful campaign are to capture attention and create action. To motivate the average person off the comfortable couch of complacency is a challenge.

If alerting the public to potential health hazards creates anxiety, and if anxiety works to push the person to seek help, this is the sign of a successful strategy that should not be abandoned because it makes people uncomfortable. Barbara I. Holleb Springfield Letters intended for publication must be signed and include the writer's home address and home and business telephone numbers. Letters may be edited. Although we are unable to acknowledge all letters, we appreciate the time and value the viewpoints of those who write. Send letters to Health Section, The Washington Post, 1150 15th St. NW, Washington, D.C. 20071.