Factors to consider when deciding on breast augmentation
- Whatever type of surgery we are talking about (cosmetic or reconstructive), it must be remembered that this operation is not the last. After some time, additional surgery will be required. In addition, you will need to see your doctor regularly throughout your life.
- Contrary to popular belief, breast prostheses have an expiration date, so they are not permanently installed. After a while, the prosthesis will need to be removed or replaced with a new one.
- Many of the changes that will occur in your breasts after the prosthesis is installed will be irreversible. If you later decide to give up the joint replacement, you will end up with depressions, folds, wrinkles, and other cosmetic flaws.
Decreased effectiveness of mammography exams
Stents reduce the effectiveness of breast cancer diagnosis. It is necessary to inform the examining physician of the presence of the prosthesis so that he uses special techniques to minimize the risk of rupture of the shell of the prosthesis. Additionally, additional scanning in different projections may be required, which increases the dose of radiation a woman receives. However, the early detection of breast cancer justifies the associated risks.
It is recommended to undergo a mammographic examination the day before the operation and then 6 to 12 months after placement of the implant. The images obtained will allow further tracking of the changes occurring in the mammary glands.
Self-examination of the mammary glands
After installation of the implant, it is necessary to conduct an independent examination of the mammary glands every month. Ask your doctor to explain how to tell the difference between a prosthesis and breast tissue. If lumps or suspicious changes are detected, a biopsy should be taken. When doing this, be careful not to damage the implant.
Closed capsulotomy
Closed capsulotomy, which involves compressing the fibrous tissue formed around the implant in order to rupture the capsule, is not recommended because 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 / rupture of the prosthesis
If the integrity of the shell is violated, the prosthesis may collapse. It can be instantaneous or progressive. Outwardly, it looks like a change in the size or shape of the breast. Collapse of the prosthesis can occur both in the first months after the operation and after several years. The reason may be damage to the prosthesis by surgical instruments during the operation, capsular contracture, closed capsulotomy, external pressure (for example, with severe trauma or compression of the breast, excessive compression during mammography), with an umbilical incision, as well as for unknown / unexplained reasons.
It should be remembered that the prosthesis wears out over time, which can lead to its rupture / collapse. Further surgery is required to remove the dormant 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 more 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 required 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 the capsular contracture recurrence.
Pain
After implantation of a breast prosthesis, painful sensations of varying 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, improper placement, surgical errors, and capsular contracture. In the event of severe pain, notify the attending physician.
Additional surgery
After a while, it may be necessary to perform surgery to replace or remove the prosthesis. Additionally, surgery to remove the prosthesis may be necessary 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 should 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, displacement of the implant, incorrect size, unwanted shape, palpability of the implant, rough (irregular shape, raised) and / or too big or wide seam.
The likelihood of these faults can be reduced by carefully planning the operation and choosing the right technique. However, even in this case, such a possibility cannot be completely excluded.
Infection
Any surgery is associated with a risk of infection. In most cases, the infection develops a few days or weeks after surgery. If the infection cannot be controlled with antibiotics and the presence of an implant makes treatment difficult, it may be necessary to remove the prosthesis. Placing a new implant is only possible after healing.
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 a rash. If these symptoms appear, you should immediately consult a doctor and start treatment.
Hematoma / seroma
A hematoma is an accumulation of blood (in this case, around an implant or an incision), and a seroma is an accumulation of serous fluid, which is the watery component of the blood. Postoperative hematoma and seroma may contribute to infection and / or capsular contracture and be accompanied by swelling, pain, and bruising. The formation of a hematoma is most likely in the postoperative period. However, he can appear at any other time with a bruised chest. Usually, small bruises and seromas go away on their own. Large bruises or seromas may require drainage. In some cases, a small scar is left after removing the drainage tube. When placing a 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 of the nipple and breast may change. The changes vary widely - from significant sensitivity to lack of sensation. These changes can be temporary and irreversible, affecting sexual sensitivity or the ability to breastfeed.
Breastfeeding
So far, it has not been possible to obtain data confirming the diffusion of small amounts of silicone from the shell of the prosthesis into the surrounding tissues and their entry into breast milk. It is also not known what effect silicone can have on a baby if it is ingested with breast milk. There is currently no method to quantify the amount of silicone in breast milk. However, a study comparing the level of silicone in breast milk of women with and without a prosthesis suggests that women with saline-filled implants and women with gel-filled implants 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% against 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 tissues surrounding the implant
On mammography, calcium deposits can be mistaken for malignant tumors. In order to differentiate them from cancerous tumors, a biopsy and / or surgical removal of the implant may be necessary in some cases.
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 scarring can lead to rejection of the prosthesis, and this will be clearly seen through the skin.
Necrosis
Necrosis, or the death of tissue around the prosthesis, can permanently deform scar tissue and prevent scarring. In such cases, it is necessary to resort to surgical correction and / or removal of the prosthesis. Often, necrosis is preceded by infection, the use of steroids to clean the surgical bag, smoking, chemotherapy / radiation therapy, and intense heat and cold therapy.
Breast tissue atrophy / chest wall deformation
The pressure exerted by the prosthesis on the breast tissue may thin and pucker. 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 prosthesis insertion and the occurrence of autoimmune or connective tissue diseases such as lupus, scleroderma or rheumatoid arthritis have emerged after reports of these conditions in a small number of women with breast enlargements. mammary glands. However, the results of a number of large epidemiological studies, which have examined women with breast prostheses and women who have never had breast surgery, indicate that the incidence of these diseases in women in both groups isapproximately the same. However, many women believe it was the prosthesis that caused their illness. According to published data, joint replacement does not increase the risk of developing breast cancer.