A Denmark study has found that women who undergo breast implant surgery after mastectomies may experience complications that require additional surgery. Approximately one-third of all patients who received reconstructive breast surgery will develop a significant breast implant complication within four years. Twenty percent of those studied required surgery to correct complications like capsular contracture and infections. The rate of implant rupture in the study was very rare: only five women out of 574 women studied experienced breast implant rupture.
The reconstructive breast surgery study was conducted by the Danish Cancer Society in conjunction with the International Epidemiology Institute. The latter paid for the study with the help of funding from former silicone implant manufacturer Dow Corning Corporation. The results of this research appear in the December issue of Archives of Surgery.
Many medical experts argue that there are significant flaws in this research. “This study is really missing the boat,” says Diana Zuckerman, president of the National Research Center for Women and Families here in the United States. She points out that most women in the Danish study received reconstructive breast surgery weeks after mastectomy, whereas most women in the United States receive breast implants during the mastectomy procedure.
With a single round of surgery, patients are spared the psychological effects of losing a breast. On the other hand, the body is put through more stress when it is made to endure both the loss of a breast and the presence of a foreign implant in its place. According to Dr. Navin Singh, a surgeon at John Hopkins University, mastectomy patients are more likely to experience complications than cosmetic breast augmentation patients are because their breast and surrounding tissues are removed during mastectomy, giving plastic surgeons less to work with. Undergoing chemotherapy and radiation after a combo surgery can also increase the risk of implant complications, says Dr. Singh.
Zuckerman actually reports that the rate of complication can be even greater than the study suggests. All of the women in the study got implants and most were silicone implants. Silicone implants have been restricted on the United States market since the early 1990s due to serious side effect risks. While silicone implants are not available for cosmetic purposes, these implants are still used for reconstructive breast surgery patients.
While breast implants following mastectomy are not without risk, many women still opt for reconstructive surgery. Meredith Cobb, who doctors diagnosed with breast cancer at 26, said her implants have made her “feel whole again.” While she needs another surgery to correct complications with her breast implants, she says, “I wouldn’t give them up now. A lot of people might not go through another surgery, but it’s something that I’m willing to do.
If you or a loved one has been diagnosed with breast cancer, it is likely that you will need to have a mastectomy or lumpectomy to remove the cancerous tissues and help you get better. The decision to have reconstructive breast surgery following breast cancer treatment is a big one. It is important to speak with your surgeon about the risks and benefits of reconstructive breast surgery in order to gain a realistic understanding of this plastic surgery procedure.
Breast augmentation can give you fabulous results. However, it also poses some risks that can lead to complications or unfavorable results. This page will explain the risks and complications associated with breast augmentation surgery. Risks of Breast Augmentation
Capsular contracture is a scar that forms around the implant, causing it to feel firm, look unnatural, and potentially hurt. When you see pictures of a woman with obvious implants who looks like she has “coconut breasts”, she more than likely has a severe capsular contracture. These are though to be less common and less severe with saline implants than with silicone implants, although studies are underway to determine whether this is true. If you develop a mild capsular contracture, you may not be bothered by it and may not even notice you have one. If you develop one that is moderate or severe, you will probably require breast surgery to correct the problem. Surgery involves removing the scar and replacing it with a new breast implant. In spite of this, the capsular contracture may return.
Placing the breast implant under the muscle has a lower risk of capsular contracture than placing the implant over the muscle. Talk with your plastic surgeon about other ways to help minimize capsular contracture.
Interference with Mammography
Breast implants do interfere with the ability of a mammogram to “see” all of your breast tissue. Placing the implant under the muscle allows for the least amount of interference. With the breast implant under your muscle, mammograms can “see” about 90% of your breast tissue. With the breast implant over the muscle (AKA under the breast), mammograms can “see” 75% of your breast tissue. Whether under of over the muscle, implants do not interfere with your ability to detect lumps in a self breast examination. Self exams are found to be the most successful way in discovering the majority of breast cancers. Implants also do not interfere with ultrasound or MRI scans, which are helpful in the evaluation of breast masses.
Breast Implant Displacement
Breast implants can move out of position at anytime after breast augmentation surgery. They can move upward, downward, left or right. If they move only a little, you may not even notice. If they move a lot, you may need further surgery to move them back into position. Fortunately, this problem is not common. The larger the implant, the greater the chance that it will displace downward. Find out more about breast implant displacement.
Saline Implant Deflation
Saline implants can develop a leak and deflate. If this happens, your breast will shrink to its preoperative size over a matter of a day or so. You will need another breast augmentation surgery to replace the deflated implant. Implant deflation is most likely to occur in implants that have not been overfilled. Yes, you read that right. Overfilling breast implants reduces deflation. This is because deflation is a result of folding of the implant shell, which occurs repetitively in implants that are not overfilled. After the implant shell has folded hundreds or thousands of times with your natural body movement, the implant shell tears – just like a piece of paper that has been folded time after time. Risk of deflation is about 4% during the first year following breast augmentation surgery , the chance is then about 1% per implant per year for each year thereafter.
Silicone Implant Rupture
Whereas saline implants are said to deflate when the silicone shell becomes disrupted, silicone gel breast implants are said to rupture. It really is the same thing, except that when silicone gel implant shells rupture, the silicone does not become quickly reabsorbed by your body. Hence, you might not know whether you have a rupture. If silicone gel extrudes out of the implant shell, then it might provoke an inflammatory response, leading to…that’s right….a capsular contracture. This is often the first sign of a silicone gel implant rupture. Whereas ruptures occurred with great frequency in implants made in the 1980’s, the newer silicone gel implants have thicker shells and are presumed to have a lower rupture rate (studies are underway). If you develop a moderate or severe capsular contracture with a silicone gel breast implant, then the usual treatment is surgical removal of the implant along with the capsule, which is really made up of surrounding scar tissue. A new implant can be placed at the same time. Find out more about silicone gel implant rupture.
This is the visible appearance of waviness of the skin over your implants, like the ripples of a wave on a lake. Some doctors refer to this as “wrinkling.” The rippling occurs due to saline shifting around inside your implants.
It is most troublesome if it occurs in the upper half of the breast, because it would be evident in low-cut clothing and swim wear. Rippling is uncommon when the implants are over filled and is less common with smooth implants than with textured ones. Also, when the implants are placed under the muscle, there is less chance of rippling in the upper half of the breast. Rippling is much less common with silicone than saline implants.
Infection, if it occurs, usually does so within two months of breast surgery. Infection occurs in about 1% of all implant surgeries. If an infection occurs it often requires antibiotics and the removal of the involved implant. A new implant can be placed six months later, which means you would have to go for six months with very uneven breasts. Find out more about breast implant infections.
If the possibility of having numb nipples is unacceptable to you, you should not have breast augmentation because no plastic surgeon can guarantee preservation of nipple sensation. The national risk of having permanently numb nipples is about 15%. Find out more about breast numbness and changes in sensation.
Breast Feeding and Pregnancy
Breast feeding ability is not altered by implants. Many women ask about the effect of future pregnancy on augmented breasts. In most cases, implants will not affect the fate of your postpartum breasts. Here is why: following pregnancy (and breast feeding), your breasts will shrink to their pre-pregnancy size (or there about). During this process of shrinking, your breast skin may either tighten or not tighten. If it tightens, you will most likely not have breast droop. If it does not tighten, then your breasts will unfortunately droop. Whether or not the skin tightens has little or nothing to do with the presence or absence of breast implants.
Need for Further Breast Surgery
Women unwilling to accept the potential need for further surgery should not have breast augmentation. Understand that if you receive any implant in your body – whether it be a pace maker, artificial joint, artificial heart valve, or anything – that one of the inherent risks is that you may need further surgery on it at some point in your life. With breast implants, you may need further surgery for capsular contracture, deflation, rippling, displacement, infection, desire for a different size, or another reason. You may also go a lifetime without having any problems. But, it is most prudent to assume that at some point, you will probably want or need another surgery to address one of these problems. To reduce your risk of needing further breast surgery, be sure to visit Breast Augmentation Tips for getting the best results. Information on that page will help you to reduce your risks, expedite your recovery, and ensure the best result. To help you better understand the decisions that might help you reduce the risks on this page, be sure to visit Options in Breast Augmentation Surgery.