Factors to Consider When Deciding on Breast Augmentation
- Regardless of what kind of surgery we are talking about (cosmetic or reconstructive), it should be remembered that this operation is not the last one. After a certain time, additional surgical intervention will be required. In addition, you will have to see your doctor regularly throughout your life.
- Contrary to popular belief, breast prostheses have an expiration date, therefore, they are not installed permanently. After a certain time, the prosthesis will have to be removed or replaced with a new one.
- Many changes that will occur to your breasts after the prosthesis is installed will be irreversible. If you later decide to abandon arthroplasty, you will be left with depressions, folds, wrinkles and other cosmetic defects.
Decreased effectiveness of mammography examinations
Endoprosthetics reduces the effectiveness of breast cancer diagnostics. It is necessary to inform the examining 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 scanning in different projections may be required, which increases the dose of radiation that a woman receives. However, early detection of breast cancer justifies the associated risks.
It is recommended to undergo a mammography examination on the eve of the operation and then 6-12 months after the installation of the implant. The images obtained will make it possible to further monitor the changes occurring in the mammary glands.
Self-examination of the mammary glands
After installing the implant, it is necessary to conduct 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 any suspicious changes are found, a biopsy should be done. When doing this, be careful not to damage the implant.
Closed capsulotomy
Closed capsulotomy, which involves squeezing the fibrous tissue formed around the implant in order to rupture the capsule, is not recommended, as 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 gradual. Outwardly, 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, capsular contracture, closed capsulotomy, external pressure (for example, with trauma or intense squeezing of the chest, 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. Additional surgery is needed to remove the dormant prosthesis and install a new one.
Capsular contracture
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 observed when the prosthesis is placed under the pancreas. Typical symptoms are breast thickening and discomfort, pain, breast shape change, implant protrusion and / or displacement.
In case of excessive compaction and / or severe pain, surgery is necessary 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 recurrent capsular contracture.
Pain
After implantation of a breast prosthesis, pain 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, poor placement, surgical errors, and capsular contracture. If severe pain occurs, notify the attending physician.
Additional surgical intervention
After a certain time, it may be necessary to perform surgical intervention in order to replace or remove the prosthesis. In addition, surgery to remove the prosthesis may be required when the prosthesis collapses, capsular contracture, infection, displacement of the prosthesis 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, implant displacement, incorrect size, unwanted shape, palpability of the implant, rough (irregularly shaped, raised) and / or too large or wide seam.
The likelihood of these defects can be reduced by carefully planning the operation and choosing the right technique. However, even in this case, such a possibility cannot be completely ruled out.
Infection
Any surgical intervention 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, it may be necessary to remove the prosthesis. Installation of a new implant is possible only after recovery.
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 begin 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 blood. Postoperative hematoma and seroma can 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, it can appear at any other time with a bruised chest. As a rule, small hematomas and seromas resolve on their own. Large bruises or seromas may require drainage. In some cases, a small scar is left after the drainage tube is removed. When inserting a drain, it is important not to damage the implant, which can lead to collapse / rupture of the prosthesis.
Sensation changes in the nipple and breast area
After the implantation of the prosthesis, the sensitivity in the nipple and breast area may change. Changes vary widely - from significant sensitivity to the absence of any sensations. These changes can be temporary and irreversible, affecting sexual sensitivity or breastfeeding ability.
Breast-feeding
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 tissue and their entry into breast milk. It is also not known what effect silicone may have on a baby if it is ingested with mother's 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 gel prostheses have similar rates.
With regard to the ability to breastfeed, according to the survey, the proportion of women unable to breastfeed among women with implants was 64% versus 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 surrounding the implant
On mammography, calcium deposits can be mistaken for malignant tumors. In order to differentiate them from cancerous growths, biopsy and / or surgical removal of the implant may be required in some cases.
Delayed wound healing
In some cases, the incision may take a long time to heal.
Rejection of the prosthesis
Insufficient thickness of the skin flap covering the prosthesis and / or prolonged wound healing can lead to the rejection of the prosthesis, and it will clearly show through the skin.
Necrosis
Necrosis, or tissue death around the prosthesis, can permanently deform scar tissue and prevent wound healing. In such cases, it is necessary to resort to surgical correction and / or removal of the prosthesis. Often, necrosis is preceded by infection, use of steroids to clean the surgical pocket, smoking, chemotherapy / radiotherapy, and intense thermal and cold therapy.
Breast tissue atrophy / chest wall deformity
The pressure exerted by the prosthesis on the breast tissue can thin and wrinkle. This can happen both with an implanted prosthesis and after its removal without replacement.
Other complications
Connective tissue diseases
Concerns about the relationship between the placement of breast prostheses and the occurrence of autoimmune or connective tissue diseases such as lupus, scleroderma or rheumatoid arthritis arose after reports of these conditions in a small number of women with breast prostheses. glands. However, the results of a number of large epidemiological studies, which examined women with breast prostheses and women who have never had breast surgery, indicate that the incidence of such diseases among women in both groups is approximately the same. Nevertheless, many women believe that it was the prosthesis that caused their illness. According to published data, arthroplasty does not increase the risk of developing breast cancer.