“The majority of plastic surgeons, even 99 percent of surgeons, would say there are problems with the directions,” said Dr. Scott L. Spear, chairman of plastic surgery at Georgetown University Hospital. “They bring a lot of red tape and expense.” As evidence of the recommendations’ unpopularity, he reported that on Tuesday most of about 150 doctors surveyed at a meeting in Coeur d’Alene, Idaho, of the American Association of Plastic Surgeons, a group of leading physicians, said they disagreed with the F.D.A.’s directives. Other surgeons said that doctors should follow the directions because much remains unknown about the durability and rate of rupture of silicone implants, which were the subject of intense and controversial class action suits in the 1990s.