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Breast implants; Things you should know.
Breast implant surgery is performed on young women who start with smaller breasts, older women who have lost breast volume especially after childbirth or as part of breast reconstruction. All surgery has inherent risks and should be very carefully considered. Breast augmentation surgery is no different.
Infection is potentially a severe problem with breast implants. Superficial infections often respond to antibiotics. Once an infection is established around the implant it is almost impossible to treat with antibiotics. Implants have no blood supply and the antibiotics cannot be delivered to treat the infection. Foreign material can protect the infecting agent. The implant may need to be removed to allow everything to settle and then a new implant re-implanted at a later stage, usually a couple of months. Every effort is made to reduce this risk. At the time of implantation most surgeons re-sterilise the skin with antiseptic, change the surgical drapes, limit contact with the implant, change gloves and even soak the implants in antibiotic or antiseptic. Severe body infections with bacteria in the blood may lodge on the implants, this is rare but reported.
Scars generally heal well but there is always a risk of thick, raised or symptomatic scars. These are known as hypertrophic or keloid scars. Treatment is usually slow and incomplete. External scars often do not represent the internal procedure. Implant scars are usually 5 cm long. Through this fairly small site, using special instruments, the surgeon dissects and creates a pocket to hold the implant. This can vary in size from 10 to 15 cm in diameter.
Another consideration with implants is that they have a limited life. Current new improved and updated implants are predicted to last between 12 and 15 years. Many older implants, with reported shorter lifespans, have been in for over 30 years. It is often the body’s response to the implants that limit the duration they remain. A scar or capsule develops around the external surface of the implant. All scars contract, the rate of contraction is variable, from months to many, many years. This rate cannot be predicted. At first the implants are noted to feel firmer, they then become visibly involved and finally they may become painful. Revision surgery is needed to excise and remove all of this scar. Implants may be removed or replaced. Textured implants are considered to have a lower rate of capsule formation. Placing the implants under the chest wall muscle may also reduce this risk.
All younger women receiving implants should factor in possible revision surgery. The longer the implants are in the more likely this becomes.
Over time the breasts may droop, particularly after pregnancy or changes in weight. This can occur even with implants. At the time of any revision surgery the breasts may need to be lifted.
Implants obscure some of the breast tissue at the time of mammograms or breast screening. It is possible to perform extra views or displace the breast tissue from the implants to limit this. Other modalities of screening may be used such as ultrasound or MRI. Placing the implants under the chest wall muscle is considered to reduce the amount of breast tissue that is obscured. Needle biopsies of breast tissue should be very carefully performed and may need ultrasound guidance. Implants are not associated with any increased risk of developing breast cancers or breast disease.
It is usually still possible to breast feed after breast implant surgery. Most implants are placed deep to the breast tissue. Some surgeons feel that the incisions placed close to the areolar may influence ability to breast feed. Other feel the risk of infection may be slightly higher with this incision as some ducts may be cut. Ducts link the breast glands to the outside as they open onto the nipple.
Implants can move and rotate. This is not common and is more important with shaped implants. If a round implant rotates it does not affect the external appearance as the base diameter and shape remain unchanged.
Despite this long list, breast augmentation surgery is well tolerated with very pleasing outcomes. All surgery should be carefully considered and all risks and concerns discussed thoroughly with your surgeon.