Factors to consider when deciding on breast augmentation
- No matter what kind of surgery we are talking about (cosmetic or reconstructive), it should be remembered that this operation is not the last. After some time, additional surgery will be required. You will also need to see your doctor regularly throughout your life.
- Contrary to popular belief, breast prostheses have an expiration date, so they are not installed permanently. After some time, the prosthesis will have to be removed or replaced with a new one.
- Many changes that will occur on your breast after the prosthesis is placed will be irreversible. If you later decide to give up endoprosthetics, you will be left with dents, folds, wrinkles and other cosmetic defects.
Reduced efficiency of mammography examinations
Endoprosthesis reduces the effectiveness of breast cancer diagnosis. It is necessary to inform the attending physician about the presence of the prosthesis so that he uses special techniques to minimize the risk of rupture of the prosthesis shell. In addition, additional scans in different projections may be required, which increases the radiation dose that the woman receives. However, early detection of breast cancer justifies the risks involved.
It is recommended that a mammogram be performed on the eve of surgery and then 6-12 months after implant placement. The obtained images will allow for further tracking of the changes occurring in the mammary glands.
Self-examination of the mammary glands
After the implant is installed, it is necessary to perform an independent examination of the mammary glands on a monthly basis. Ask your doctor to explain how to understand the difference between a prosthesis 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 tear the capsule, is not recommended as it may damage the prosthesis itself.
Implant complications
There is a risk of complications with any type of surgery, such as the effects of anesthesia, infection, swelling, redness, bleeding and pain. In addition, additional complications during implantation are possible.
Prosthesis collapse / rupture
If the integrity of the shell is compromised, the prosthesis may collapse. It can be instantaneous or gradual. Externally it looks like a change in the size or shape of the breast. Prosthesis failure can occur in the first months after surgery or after several years. The reason may be damage to the prosthesis by surgical instruments during the operation, capsular contracture, closed capsulotomy, external pressure (eg trauma or intense chest compression, excessive compression during mammography), umbilical incision, as well as unknownunexplained reasons.
It should be remembered that the prosthesis wears out over time, which can lead to its rupture / collapse. Additional surgery is needed to remove the sleeping prosthesis and insert a new one.
Capsule contracture
A scar tissue or capsule that forms around the implant and presses on it is called a capsular contracture. In most cases, the onset of capsular contracture is preceded by infection, hematoma, and seroma. Capsule contracture is more common when the prosthesis is placed under the pancreas. Typical symptoms are thickening and discomfort in the breast, pain, change in the shape of the breast, protrusion and / or displacement of the implant.
In case of excessive compaction and / or severe pain, surgery is required to remove the capsule 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 pinching nerves or difficulty contracting muscles, which can be caused by improperly sized prostheses, poor placement, surgical errors and capsular contracture. If severe pain occurs, tell your doctor.
Additional surgical intervention
After some time, it may be necessary to perform surgery to replace or remove the prosthesis. In addition, surgery may be required to remove the prosthesis in case of prosthesis collapse, capsular contracture, infection, prosthesis displacement, and calcium deposits. Most women, after removing the old prosthesis, install a new one. Women who decide to give up the implantation of a new prosthesis should be prepared for the fact that they will develop depression and / or wrinkles 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, rough (irregular shape, raised) and / or too large or wide suture.
The likelihood of these defects can be reduced by carefully planning the operation and choosing the right technique. But even in this case, such a possibility cannot be completely ruled out.
Infection
Any surgical procedure is associated with a risk of infection. In most cases, the infection develops within a few days or 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. The installation of a new implant is possible only after restoration.
In rare cases, after the implantation of a breast prosthesis, toxic shock syndrome develops, which can be life-threatening. Symptoms include a sudden rise in body temperature, vomiting, diarrhea, fainting, dizziness and / or rash. If these symptoms occur, you should consult a doctor immediately and start treatment.
Hematoma / seroma
A hematoma is an accumulation of blood (in this case around an implant or incision), and a seroma is an accumulation of serous fluid, which is the aqueous component of the blood. Postoperative hematoma and seroma may contribute to infection and / or capsular contracture and may be accompanied by swelling, pain and bruising. Hematoma formation is most likely in the postoperative period. However, it can occur at any other time with a bruised chest. As a rule, small hematomas and seromas pass on their own. Large bruises or seromas may require drainage. In some cases, a small scar remains after the drain pipe is removed. When placing a drain, it is important that the implant is not damaged, which can lead to collapse / rupture of the prosthesis.
Changes in the sensation in the nipple and chest
After implantation of the prosthesis, the sensitivity in the area of the nipple and breast may change. The changes vary widely - from significant sensitivity to lack of any sensations. These changes may be temporary and irreversible, affecting sexual sensitivity or the ability to breastfeed.
Breastfeeding
Until now, it has not been possible to obtain data confirming the diffusion of small amounts of silicone from the prosthesis shell into the surrounding tissues and their entry into breast milk. It is also not known what effect silicone can have on the baby if ingested with breast milk. There are currently no methods for quantifying the amount of silicone in breast milk. However, a study comparing the level of silicone in the breast milk of women with and without dentures suggests that women with saline-filled implants and women with gel dentures have similar levels.
Regarding the ability to breastfeed, according to the study, the share of women who cannot breastfeed among women with implants is 64% compared to 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 around the implant
In mammography, calcium deposits can be mistaken for malignant tumors. In some cases, a biopsy and / or surgical removal of the implant may be needed to differentiate them from cancer.
Delayed wound healing
In some cases, the incision may take a long time to heal.
Rejection of the prosthesis
Insufficient thickness of the skin valve covering the prosthesis and / or prolonged wound healing can lead to rejection of the prosthesis and it will be clearly visible through the skin.
Necrosis
Necrosis or death of the tissue around the prosthesis can permanently deform scars 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 clean the surgical pocket, smoking, chemotherapy / radiation, and intensive heat and cold therapy.
Chest atrophy / chest wall deformity
The pressure exerted by the prosthesis on the breast tissue may become thinner and wrinkle. This can happen both with an implanted prosthesis and after its removal without replacement.
Other complications
Connective tissue diseases
Concerns about the link between breast implants and the development of autoimmune or connective tissue diseases such as lupus, scleroderma or rheumatoid arthritis have emerged following reports of these conditions in a small number of women with breast implants. The results of a number of large epidemiological studies examining women with breast prostheses and women who have never had breast surgery show that the incidence of such diseases among women in both groups is approximately the same. However, many women believe that dentures are the cause of their illness. According to published data, endoprosthetics do not increase the risk of developing breast cancer.