Nine patients have been identified as having received PIP breast implants in Malta to date but no adverse reports have been reported, the government said this morning.

Investigations are ongoing.

A spokesman for Saint James Hospital said the implants, manufactured by the now-bankrupt French company, Poly Implant Prothese, were used many years ago by a general surgeon and the three Maltese women who underwent the breast augmentation surgery had been recalled for free replacements three years ago.

Those in the field have been aware of the issue for a while, the spokesman said, even though the scare has just hit the headlines with news that over 250 British women are taking court action after more than half experienced ruptures in their PIP-manufactured implants. They are among up to 50,000 women in Britain who have had these implants, according to media reports.

Breast augmentation is growing in popularity in Malta and the figures have doubled at Saint James Hospital over the last three years, the spokesman said, adding that it remained the cosmetic intervention most in demand locally as opposed to liposuction overseas.

A spokesman for St Anne’s Clinic, which also carries out this popular cosmetic surgery, said it never used the product in question, adding that some patients could have done the intervention, using PIP, abroad.

The clinic has, nonetheless, received several inquiries from concerned women and was referring them to plastic surgeon Ray Debono.

To bury any undue alarm and play down the scare, Mr Debono stressed the problem was “specific” to the PIP breast implants, which he never utilised and are unlikely to have been used in Malta recently.

Such implants were made of an unauthorised silicone of a non-medical grade, which, therefore, had a high rupture rate – 10 per cent up from around two, Mr Debono explained.

About three years ago, surgeons started to notice the higher rupture rates and reported them. They were investigated and stopped, he said.

Nevertheless, women with implants should check the brand, he recommended. If it is not PIP, there is no cause for alarm, and if it is, they should make an appointment with their surgeon to discuss further action.

Mr Debono said patients would be aware of a problem as they would experience signs in the case of a rupture. The breasts would either deflate, change shape or harden.

Different countries are taking different approaches, with France planning to remove the implants in every case of PIP use, whether ruptured, or not, and the UK adopting a more “relaxed” attitude and only explanting in the case of rupture.

Health officials in France said the government planned to recommend to 30,000 French women with PIP implants to remove them, based on an expert report that should be released in the country today. European authorities yesterday sought to head off panic over the scare, saying there was no proof of a link to cancer, and Mr Debono too rubbished any correlation between breast cancer and implants.

Plastic surgeon Francis X. Darmanin, who never used the product, said eight out of 50,000 were in any case way below the average one in 10 women in Malta who contracted breast cancer, putting the statisticsinto perspective. He also played down the “hype”, in line with the British Association of Plastic Surgeons, which is recommending no need for replacements unless problems arise.

He too has received inquiries from patients and reassured them the implants used were “extremely safe”, saying they could easily check as they were always given their detailed information, including serial numbers.

Mr Darmanin pointed to the possibility of competing companies highlighting the problem so that women change their implants to the advantage of such businesses, adding it was common to try and find complications in others’ products.

In a statement this morning, the government said that there was no cause for alarm and patients who may be affected will be informed of any action that may need to be taken in respect of their implant should such need arise.

"In case of doubt such women are advised to contact the surgeon who performed the operation. 

"It is to be stressed that these issues concern these specific PIP implants and have no relevance to other types of implants," it said.