Factors to Consider When Deciding on Breast Augmentation
- No matter what kind of surgery we are talking about (cosmetic or reconstructive), we must remember that this surgery is not the last. After some time, additional surgery will be required. In addition, you should see your doctor regularly throughout your life.
- Contrary to popular belief, breast implants have an expiration date, so they are not placed permanently. After a certain period of time, the intention should be removed or replaced with a new one.
- Many changes that will occur in your breast after the prosthesis is placed will be irreversible. If you decide to give up arthroplasty later, you will be left with depressions, wrinkles, wrinkles and other cosmetic defects.
Reduced efficiency of mammography examinations
Endoprosthesis reduces the effectiveness of breast cancer diagnostics. It is necessary to inform the examining physician about the presence of the prosthesis in order to use special techniques to minimize the risk of rupture of the prosthesis shell. In addition, additional scanning in different views may be required, which increases the radiation dose a woman receives. However, early detection of breast cancer justifies the risks involved.
It is recommended to have a mammogram on the eve of the operation and then 6-12 months after the implant placement. The images taken will make it possible to further monitor the changes that occur in the mammary glands.
Self-examination of the mammary glands
After the installation of the implant, it is necessary to perform an independent examination of the mammary glands on a monthly basis. Ask your doctor to explain how to tell the difference between a prosthesis and breast tissue. If lumps or suspicious changes are found, a biopsy should be done. When doing this, be careful not to damage the implant.
Closed capsotomy
Closed capsotomy, which involves compressing the fibrous tissue that forms around the implant in order to rupture the capsule, is not recommended, as it may damage the prosthesis itself.
Complications related to 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 intention
If the integrity of the shell is violated, the prosthesis may collapse. It can be instantaneous or gradual. Externally, it looks like a change in the size or shape of the breast. The 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, contraction of the capsule, closed capsotomy, external pressure (eg with trauma or intense compression of the chest, excessive compression during mammography), with umbilical incision, as well asfor unknown / unexplained reasons.
We must remember that the intention wears out over time, which can lead to its rupture / collapse. Additional surgery is required to remove the inactive prosthesis and install a new one.
Capsic contraction
The scar tissue or capsule that forms around the implant and compresses it is called capsular contraction. In most cases, the onset of capsule contraction is preceded by infection, hematoma, and serum. Capsule contraction is most often seen when the prosthesis is placed under the pancreas. Typical symptoms are thickening and discomfort of the breast, pain, change in breast shape, protrusion and / or displacement of the implant.
In case of excessive concentration 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 recurrence of the capsule contraction.
Pain
After implanting a breast prosthesis, sensations of pain of varying intensity and duration are possible. This pain occurs as a result of strained nerves or difficult muscle contraction, which can be caused by improper prosthesis size, poor placement, surgical errors, and capsule contraction. If severe pain occurs, tell your doctor.
Additional surgery
After a period of time, surgery may be needed to replace or remove the prosthesis. In addition, surgery may be required to remove the prosthesis when the prosthesis collapses, the capsule shrinks, infection, displacement of the prosthesis, and the appearance of calcium deposits. Most women, after removing the old prosthesis, place 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 wrinkles and other cosmetic defects.
Dissatisfaction with the cosmetic result
The aesthetic result of the operation may not always satisfy the patient. Possible wrinkles, asymmetry, implant displacement, wrong size, unwanted shape, palpability of the implant, rough (irregular shape, raised) and / or very large or wide seam.
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 can not be completely ruled out.
Contamination
Any surgery is associated with the 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, you may need to remove the prosthesis. The installation of a new implant is only possible after recovery.
In rare cases, toxic shock syndrome develops after the implantation of a breast prosthesis, 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 / serum
A hematoma is an accumulation of blood (in this case, around an implant or an incision) and a seroma is an accumulation of serum fluid, which is the aqueous component of blood. Postoperative hematoma and seroma may contribute to infection and / or contraction of the capsule and 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 cavities subside on their own. Large bruises or sera may require drainage. In some cases, a small scar is left after the drain is removed. When inserting a drain, it is important not to damage the implant, as this may cause the prosthesis to collapse / rupture.
Sensory changes in the nipple and breast area
After the prosthesis is implanted, the sensitivity in the nipple and breast area may change. The changes vary widely - from significant sensitivity to the absence of any senses. These changes can be temporary and irreversible, affecting sexual sensitivity or the ability to breastfeed.
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 their entry into breast milk. It is also not known what effect silicone can have on a baby if swallowed with breast milk. There are currently no methods 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 prostheses suggests that women with saline-filled implants and women with prosthetic gel have similar rates.
In terms of breastfeeding ability, according to the survey, the percentage of women who could not breastfeed among women with implants was 64% versus 7% among women without implants. When the prosthesis is implanted through the nipple incision, the ability to breastfeed is significantly reduced.
Calcium deposition in the tissue surrounding the implant
On mammography, calcium deposits may be mistaken for malignancies. In order to differentiate them from cancerous growths, in some cases a biopsy and / or surgical removal of the implant may be required.
Delayed wound healing
In some cases, the incision may take a long time to heal.
Reject the addition
Insufficient thickness of the dermal fin covering the prosthesis and / or prolonged wound healing can lead to the rejection of the prosthesis and will be clearly visible through the skin.
Necrosis
Necrosis or death of the tissues around the prosthesis can permanently deform the scar tissue and prevent the wound from 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 pouch, smoking, chemotherapy / radiotherapy, and intense heat and cold therapy.
Breast tissue atrophy / thoracic wall deformity
The pressure exerted by the prosthesis on the breast tissue can become thinner and wrinkled. 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 augmentation and the occurrence of autoimmune diseases 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 prostheses. However, the results of a series 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 about the same. However, many women believe that it was the intention that caused their illness. According to published data, arthroplasty does not increase the risk of breast cancer.