Factors to Consider When Choosing Breast Augmentation
- No matter what surgery we are talking about (cosmetic or restorative), it must be remembered that this surgery is not the last. After some time, additional surgery will be needed. In addition, you should see your doctor regularly throughout your life.
- Contrary to popular belief, breast prostheses have an expiration date and are therefore not fitted permanently. After a period of time, the prosthesis must be removed or replaced again.
- After the prosthesis is inserted, many of the changes that occur in the breasts will be irreversible. If you later decide to leave the joint plastic, there will be depressions, wrinkles, wrinkles and other cosmetic defects left.
Decreased efficiency of mammographic examinations
Endoprosthesis reduces the effectiveness of breast cancer diagnosis. The presence of the prosthesis should be reported to the examining physician to minimize the risk of cracking of the prosthesis shell using special techniques. In addition, additional scanning may be required in various projections, which increases the dose of radiation received by the woman. However, early detection of breast cancer justifies the associated risks.
Mammography is recommended on the eve of surgery and 6 to 12 months after implant placement. The images obtained allow further monitoring of changes in the mammary glands.
Self-examination of the mammary glands
An independent examination of the mammary glands should be performed monthly after implant placement. Ask your doctor to explain how to distinguish between a prosthesis and breast tissue. If nodules or any suspected lesions are found, a biopsy should be performed. In doing so, be careful not to damage the implant.
Closed capsulotomy
Closed capsulotomy, in which the fibrous tissue formed around the implant is compressed to rupture the capsule, is not recommended, as this can damage the prosthesis itself.
Complications related to implantation
There is a risk of complications from any type of surgery, such as anesthesia, infection, swelling, redness, bleeding and pain. However, additional complications are possible during implantation.
Collapse / rupture of the prosthesis
If the integrity of the shell is compromised, the prosthesis may collapse. It can be immediate or gradual. On the outside, it looks like a change in the size or shape of the breast. Collapse of the prosthesis can occur in the first months after surgery and after several years. Surgical damage to the prosthesis during surgery, sheath contracture, closed capsulotomy, external pressure (eg trauma or intense compression of the chest, excessive compression during mammography), umbilical cord surgery, orfor unknown / unexplained reasons.
It should be recalled that the prosthesis wears out over time, which can lead to rupture / collapse. Additional surgery is needed to remove the sleeping 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 development of capsular contracture is preceded by infection, hematoma, and seroma. Capsular contracture is more common when the prosthesis is placed under the pancreas. Typical symptoms include thickening and discomfort of the breast, pain, breast deformity, protrusion and / or displacement of the implant.
Excessive compression and / or severe pain may require surgery to remove and possibly replace the sheath tissue or the implant itself. However, this does not rule out the risk of recurrence of the capsule contracture.
Pain
After implantation of a breast prosthesis, pain of varying intensity and duration is possible. This pain occurs as a result of nerve pinching or severe muscle contraction, which can be caused by improperly sized prostheses, poor placement, surgical defects, and capsule contracture. If you experience severe pain, tell your doctor.
Further surgery
After a certain period of time, surgery may be needed to replace or remove the prosthesis. In addition, surgery may be needed to remove the prosthesis if the prosthesis collapses, sheath contracture, infection, the prosthesis moves, and calcium deposits appear. Most women install a new one after removing the old prosthesis. Women who choose not to have a new prosthesis implanted should be prepared for dents and / or wrinkles and other cosmetic defects.
Dissatisfaction with the cosmetic effect
The cosmetic effect of surgery does not always satisfy the patient. Possible wrinkles, asymmetry, implant displacement, improper size, unwanted shape, implant palpability, rough (irregular shape, convex) and / or too large or wide suture.
The likelihood of these errors can be reduced by carefully planning the operation and selecting the appropriate technique. However, even in this case, this possibility cannot be completely ruled out.
Infection
There is a risk of infection from any surgery. In most cases, the infection develops within a few days or weeks of surgery. If the infection cannot be controlled with antibiotics and the presence of the implant makes treatment difficult, it may be necessary to remove the prosthesis. Implantation of 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 rise in body temperature, vomiting, diarrhea, fainting, dizziness and / or rash. If these symptoms occur, 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 serum fluid that is an aqueous component of blood. Postoperative hematoma and seroma can contribute to infection and / or shrinkage, and can cause swelling, pain, and bruising. Hematoma is most likely to develop in the postoperative period. However, it can appear at any other time with a bruised chest. Usually, small hematomas and seromas resolve on their own. Large bruises or seromas may require drainage. In some cases, a small scar remains after the drain pipe is removed. When inserting the drain, it is important not to damage the implant, which could lead to collapse / cracking of the prosthesis.
Sensory changes in the nipple and breast area
Sensitivity may change in the nipple and breast area after implantation. Changes vary widely - from significant sensitivity to a lack of feelings. These changes may be temporary and irreversible, affecting sexual sensitivity or ability to breastfeed.
Breast-feeding
To date, no data have been obtained to confirm the diffusion of small amounts of silicone from the prosthesis shell into the surrounding tissues or into breast milk. It is also not known what effect silicone can have on the baby if swallowed with breast milk. There is currently no method to determine the amount of silicone in breast milk. However, a study comparing silicone levels in breast milk of prosthetic and non-prosthetic women suggests that women with saline-filled implants and women with gel prostheses show a similar proportion.
In terms of breastfeeding capacity, the survey found that the proportion of women unable to breastfeed is 64% of women with implants, compared with 7% of women without implants. If the prosthesis is implanted through an incision in the areola, the ability to breastfeed is significantly reduced.
Calcium deposition in the tissue surrounding the implant
In mammography, calcium deposits can be confused with malignancies. In some cases, biopsy and / or surgical removal of the implant may be required to differentiate between cancerous tumors.
Delayed wound healing
In some cases, the incision may take a long time to heal.
Rejection of the prosthesis
Inadequate thickness of the skin flap covering the prosthesis and / or prolonged healing of the wounds may cause the prosthesis to be rejected and be clearly visible on the skin.
Necrosis
Tissue death around the necrosis or prosthesis can permanently deform the scar tissue and prevent wound healing. In such cases, surgical correction and / or removal of the prosthesis should be used. Necrosis is often preceded by infection, the use of steroids to clean the surgical pocket, smoking, chemotherapy / radiation, and intensive heat and cold therapy.
Breast tissue atrophy / chest wall deformity
The pressure exerted on the breast tissue by the prosthesis may become thinner and wrinkled. This can also happen with an implanted prosthesis and its removal without replacement.
Other complications
Connective tissue diseases
Concerns about the association between the placement of breast prostheses and the incidence of autoimmune or connective tissue diseases such as lupus, scleroderma, or rheumatoid arthritis have arisen since these conditions were reported in women with a small number of breast prostheses. However, the results of several large epidemiological studies in women with breast prostheses and in women who have not had breast surgery show that the incidence of such diseases is approximately the same in both groups. Nevertheless, many women believe that the prosthesis caused their illness. According to published data, joint surgery does not increase the risk of developing breast cancer.