Factors to Consider When Deciding on Breast Augmentation
- Regardless of what type of surgery we are talking about (cosmetic or reconstructive), it should be remembered that this surgery is not the last. After a certain time, additional surgical intervention will be required. In addition, you should see your doctor regularly throughout your life.
- Contrary to popular belief, breast prostheses have an expiration date, therefore, they are not permanently installed. After a certain time, the prosthesis needs to be removed or replaced with a new one.
- Many of the changes that will occur to your breasts after the prosthesis is installed will be irreversible. If you later decide to leave arthroplasty, you will experience dents, creases, wrinkles and other cosmetic defects.
Decreased effectiveness of mammographic screening
Endoprosthetics reduce the diagnostic effectiveness of breast cancer. It is necessary to inform the examining doctor about the presence of a prosthesis so that he uses special techniques to minimize the risk of rupture of the shell of the prosthesis. In addition, additional scans in different projections may be required, which increases the radiation dose received by women. However, early detection of breast cancer allows for associated risks.
It is recommended to undergo a mammographic examination the night before surgery and then 6-12 months after implant placement. The images obtained will allow to further monitor the changes that take place in the mammary glands.
Self -examination of the mammary glands
After installing the implants, it is necessary to conduct an independent examination of the mammary glands every month. Ask your doctor to explain how to differentiate between prostheses and breast tissue. If lumps or any suspicious changes are found, a biopsy should be performed. When doing this, be careful not to damage the implant.
Closed capsulotomy
Closed capsulotomy, which involves 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 may occur during implantation.
Prosthesis collapsed / ruptured
If the integrity of the shell is violated, the prosthesis may collapse. It can be immediate or gradual. Externally, it looks like a change in the size or shape of the breast. Prosthesis collapse can occur in the first month after surgery, and after several years. The reasons may be damage to the prosthesis by surgical instruments during surgery, capsule contraction, closed capsulotomy, external pressure (e. g. , with trauma or strong chest compression, excessive compression during mammography), by umbilical incision, as well as for unknown / unexplained reasons.
Keep in mind that prostheses wear out over time, which can cause rupture / collapse. Additional surgery is required to remove the inactive prosthesis and install a new one.
Capsule contracture
The scar tissue or capsule that forms around the implant and compresses it is called capsule contracture. In most cases, the onset of capsule contraction is preceded by infection, hematoma, and seroma. Capsule contraction is more frequently observed when the prosthesis is placed below the pancreas. Common symptoms are thickened and uncomfortable breasts, pain, breast deformity, implant protrusion and / or displacement.
In cases of excessive compaction and / or severe pain, surgery is required to remove the capsule or implant tissue itself and possibly replace it with a new one. However, this does not eliminate the risk of repetition of capsule contracture.
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After implantation of a breast prosthesis, pain of varying intensity and duration may occur. This pain occurs as a result of pinched nerves or difficult muscle contraction, which can be caused by an incorrectly sized prosthesis, poor placement, surgical errors, and capsule contracture. If severe pain occurs, inform the treating physician.
Additional surgical intervention
After a certain time, it may be necessary to perform surgical intervention to replace or remove the prosthesis. In addition, surgery to remove the prosthesis may be required when the prosthesis collapses, capsule contractures, infection, prosthesis displacement and the appearance of calcium deposits. Most women, after removing an old prosthesis, install a new one. Women who decide to abandon the implantation of a new prosthesis should be prepared for the fact that they will experience depression and / or folds and other cosmetic defects.
Dissatisfaction with cosmetic effects
The cosmetic effects of surgery may not always satisfy the patient. Possible wrinkles, asymmetry, implant displacement, incorrect size, unwanted shape, palpability of the implant, rough (irregularly shaped, raised) and/or sutures are too large or wide.
The possibility of these defects can be reduced by carefully planning the operation and choosing the right technique. However, even in this case, such a possibility cannot be completely ruled out.
Infection
Any surgical intervention is associated with a risk of infection. In most cases, the infection develops within days or weeks after surgery. If the infection cannot be controlled with antibiotics, and the presence of implants makes treatment difficult, it may be necessary to remove the prosthesis. Installation of new implants 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 increase in body temperature, vomiting, diarrhea, fainting, dizziness, and / or rash. If these symptoms appear, you should immediately see 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 aqueous component of blood. Hematomas and seromas after surgery can contribute to infection and / or capsule contraction and are accompanied by swelling, pain, and bruising. Hematoma formation is most likely in the postoperative period. However, it can appear at any other time with a bruised chest. As a rule, hematomas and small seromas resolve on their own. Large bruises or seromas may require drainage. In some cases, small scars are left after the drainage tube is removed. When inserting the drain, it is important not to damage the implant, which can lead to collapse / rupture of the prosthesis.
Changes in sensation in the nipple and breast area
After implantation of the prosthesis, the sensitivity in the nipple and breast area may change. The changes vary widely - from significant sensitivity to the absence of any sensation. These changes can be temporary and irreversible, affecting sexual sensitivity or breastfeeding ability.
Breastfeeding
To date, it has not been possible to obtain data confirming the diffusion of small amounts of silicone from the prosthesis shell into the surrounding tissue and its entry into breast milk. It is also not known what effect silicone has on babies if it is ingested with breast milk. There is currently no method to measure the amount of silicon in breast milk. However, studies comparing silicone levels in breast milk of women with and without prostheses showed that women with saline implants and women with gel prostheses had similar rates.
With regard to the ability to breastfeed, according to the survey, the proportion of women unable to breastfeed among women with implants was 64% compared to 7% among women without implants. When the prosthesis is implanted through an incision of the areola, the ability to breastfeed is significantly reduced.
Calcium deposition in the tissues around the implant
On mammography, calcium deposits can be mistaken for malignant tumors. To differentiate it from cancerous tumors, biopsy and/or surgical removal of the implant may be required in some cases.
Slow wound healing
In some cases, the incision may take a long time to heal.
Prosthesis rejection
Insufficient skin flap thickness covering the prosthesis and / or prolonged wound healing can result in rejection of the prosthesis, and it will be clearly visible through the skin.
Necrosis
Necrosis, or death of tissue around the prosthesis, can permanently change the shape of the scar tissue and prevent wound healing. In such cases, it is necessary to use surgical correction and / or removal of the prosthesis. Often, necrosis is preceded by infection, use of steroids to clear surgical pockets, smoking, chemotherapy / radiotherapy, and intense heat and cold therapy.
Breast tissue atrophy / chest wall defects
The pressure exerted by the prosthesis on the breast tissue can thin and wrinkle. This can happen with an implanted prosthesis and after its removal without replacement.
Other complications
Connective tissue disease
Concerns about the link between breast prosthesis placement and the incidence of autoimmune or connective tissue diseases such as lupus, scleroderma or rheumatoid arthritis arose after reports of this condition in a small number of women with breast prostheses. However, the results of several large epidemiological studies, which examined women with breast prostheses and women who had never undergone breast surgery, showed that the incidence of such diseases among women in both groups was more or less the same. However, many women believe that it is the prosthesis that causes their disease. According to published data, arthroplasty does not increase the risk of getting breast cancer.