Factors to consider when deciding on breast augmentation
- Regardless of what type of surgery we are talking about (aesthetic or reconstructive), it should be remembered that this operation is not the last. After a certain time, an additional surgical intervention will be required. Also, you will need to see your doctor regularly throughout your life.
- Contrary to popular belief, breast implants have an expiration date, so they are not permanently installed. After a certain time, the prosthesis will have to be removed or replaced with a new one.
- Many of the changes that will occur in your breasts after the prosthesis installation will be irreversible. If you decide to abandon arthroplasty later, you will be left with depressions, folds, wrinkles and other cosmetic defects.
Decreased effectiveness of mammography exams.
Stenting reduces the effectiveness of breast cancer diagnostics. It is necessary to inform the examining physician about the presence of the prosthesis so that he can use special techniques to minimize the risk of breakage of the prosthesis shell. Also, an additional scan may be required in different views, increasing the radiation dose a woman receives. However, early detection of breast cancer justifies the associated risks.
It is recommended to undergo a mammogram examination on the eve of the operation and then 6 to 12 months after implant installation. The images obtained will allow you to continue monitoring the changes that occur in the mammary glands.
Self-examination of the mammary glands.
After installing the implant, it is necessary to conduct an independent examination of the mammary glands on a monthly basis. Ask your doctor to explain how to differentiate between a prosthesis and breast tissue. If lumps or any suspicious changes are found, a biopsy should be done. When doing this, be careful not to damage the implant.
Closed capsulotomy
Closed capsulotomy, which consists of squeezing the fibrous tissue formed around the implant to break the capsule, is not recommended, as it can damage the prosthesis itself.
Complications associated with implantation
There is a risk of complications with any type of surgery, such as the effects of anesthesia, infection, swelling, redness, bleeding, and pain. Along with this, additional complications are possible during implantation.
Collapse / breakage of the prosthesis
If the integrity of the shell is violated, the prosthesis can collapse. It can be instantaneous or gradual. Outwardly, it looks like a change in the size or shape of the breast. The collapse of the prosthesis can occur both in the first months after the operation, and after several years. The reason can be damage to the prosthesis by surgical instruments during the operation, capsular contracture, closed capsulotomy, external pressure (for example, with trauma or intense compression of the chest, excessive compression during mammography), with an umbilical incision, as well as by unknown / unexplained reasons.
It should be remembered that the prosthesis wears out over time, which can cause it to break / collapse. Additional surgery is needed to remove the inactive prosthesis and install a new one.
Capsular contracture
The scar tissue or capsule that forms around the implant and compresses it is called capsular contracture. In most cases, the onset of capsular contracture is preceded by infection, hematoma, and seroma. Capsular contracture is most often seen when the prosthesis is placed under the pancreas. Typical symptoms are breast thickening and discomfort, pain, change in breast shape, protrusion and / or displacement of the implant.
In case of excessive compaction and / or severe pain, surgery is necessary to remove the capsular tissue or the implant itself and possibly replace it with a new one. However, this does not eliminate the risk of recurrence of capsular contracture.
Pain
After implantation of a breast prosthesis, pain sensations of different intensity and duration are possible. This pain occurs as a result of pinched nerves or difficult muscle contraction, which can be caused by improperly sized prostheses, poor placement, surgical errors, and capsular contracture. If severe pain occurs, notify the attending physician.
Additional surgical intervention
After a certain time, it may be necessary to perform a surgical procedure to replace or remove the prosthesis. In addition, surgery may be necessary to remove the prosthesis when the prosthesis collapses, capsular contracture, infection, prosthesis displacement, and the appearance of calcium deposits. Most women, after removing the old prosthesis, install a new one. Women who decide to abandon the implantation of a new prosthesis must be prepared for the fact that they will develop depressions and / or folds and other cosmetic defects.
Dissatisfaction with the cosmetic effect.
The cosmetic effect of the operation may not always satisfy the patient. Possible wrinkles, asymmetry, implant displacement, incorrect size, unwanted shape, implant palpability, roughness (irregular shape, raised) and / or too large or wide seam.
The probability of these defects can be reduced by carefully planning the operation and choosing the correct technique. However, even in this case, such a possibility cannot be completely ruled out.
Infection
Any surgical intervention is associated with the risk of infection. In most cases, the infection develops a few days to weeks after surgery. If the infection cannot be controlled with antibiotics and the presence of an implant makes treatment difficult, the prosthesis may need to be removed. Installation of a new implant is only possible after recovery.
In rare cases, toxic shock syndrome develops after implantation of a breast prosthesis, which can be life-threatening. Symptoms include a sudden rise in body temperature, vomiting, diarrhea, fainting, dizziness, and / or a rash. If these symptoms appear, you should immediately consult a doctor and start treatment.
Hematoma / seroma
A hematoma is a collection of blood (in this case, around an implant or incision) and a seroma is a collection of serous fluid, which is the watery component of blood. Postoperative hematoma and seroma can contribute to infection and / or capsular contracture and be accompanied by swelling, pain, and bruising. The formation of a hematoma is more likely in the postoperative period. However, it can appear at any other time with a bruise on the chest. As a general rule, small bruises and seromas resolve on their own. Large bruises or seromas may require drainage. In some cases, a small scar remains after the drainage tube is removed. When inserting a drain, it is important not to damage the implant, which can lead to the collapse / rupture of the prosthesis.
Sensation changes in the nipple and breast area.
After the implantation of the prosthesis, the sensitivity in the area of the nipple and the breast can change. The changes vary widely, from significant sensitivity to no sensation. These changes can be temporary and irreversible and affect sexual sensitivity or the ability to breastfeed.
Breast-feeding
Until now, it has not been possible to obtain data confirming the diffusion of small amounts of silicone from the shell of the prosthesis to the surrounding tissue and its entry into breast milk. It is also not known what effect silicone can have on a baby if ingested with breast milk. Currently there are no methods to quantify the amount of silicone in breast milk. However, a study comparing the level of silicone in the breast milk of women with and without a prosthesis suggests that women with saline-filled implants and women with gel prostheses have similar rates.
Regarding the ability to breastfeed, according to the survey, the proportion of women unable to breastfeed among women with implants was 64% versus 7% among women without implants. When the prosthesis is implanted through the areola incision, the ability to breastfeed is significantly reduced.
Calcium deposits in the tissue surrounding the implant.
On mammography, calcium deposits can be mistaken for malignant tumors. To differentiate them from cancerous growths, in some cases a biopsy and / or surgical removal of the implant may be necessary.
Delayed wound healing
In some cases, the incision can take a long time to heal.
Rejection of the prosthesis
Insufficient thickness of the skin flap covering the prosthesis and / or prolonged wound healing can lead to rejection of the prosthesis, which will be seen clearly through the skin.
Necrosis
Necrosis, or death of the tissue around the prosthesis, can permanently deform the scar tissue and prevent wound healing. In such cases, it is necessary to resort to surgical correction and / or removal of the prosthesis. Necrosis is often preceded by infection, use of steroids to clear the surgical pocket, smoking, chemotherapy / radiation therapy, and intense heat and cold therapy.
Breast tissue atrophy / chest wall deformity
The pressure that the prosthesis exerts on the breast tissue can become thin and wrinkled. This can happen both with an implanted prosthesis and after its removal without replacement.
Other complications
Connective tissue diseases
Concerns about the relationship between breast implant placement and the development of autoimmune or connective tissue diseases such as lupus, scleroderma, or rheumatoid arthritis arose after reports of these conditions in a small number of women with breast implants. However, the results of a series of large epidemiological studies, which examined women with breast implants and women who had never had breast surgery, indicate that the incidence of such diseases among women in both groups is approximately the same. However, many women believe that it was the prosthesis that caused their disease. According to published data, arthroplasty does not increase the risk of developing breast cancer.