Factors to consider when deciding on breast augmentation
- No matter what kind of surgery you are talking about (cosmetic or reconstructive), we must remember that this surgery is not the last. Additional surgical intervention will be required after some time. In addition, you should visit your doctor regularly throughout your life.
- Contrary to popular belief, breast prostheses have an expiration date, so they are not permanently installed. After some time the prosthesis will have to be removed or replaced with a new one.
- Many of the changes that will occur after a prosthesis is placed on your chest will be irreversible. If you later decide to opt out of arthroplasty, you will be left with depressions, folds, wrinkles and other cosmetic defects.
Decreased effectiveness of mammographic examinations
Endoprosthesis reduces the effectiveness of breast cancer diagnosis. It is necessary to inform the examining physician about the presence of the prosthesis so that he can use special techniques to reduce the risk of rupture of the prosthetic membrane. In addition, additional scans in different projections may be required, which increases the dose of radiation received by the woman. However, early detection of breast cancer justifies the associated risks.
It is recommended to have a mammographic examination the day before the operation and 6-12 months after implant placement. The obtained images will make it possible to further monitor the changes in the mammary glands.
Self-examination of the mammary glands
An independent examination of the mammary glands is necessary every month after implant placement. Ask your doctor to explain how to distinguish between a prosthesis and breast tissue. If tumors 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 compressing the fibrous tissue that forms around the implant to rupture the capsule, is not recommended as this may damage the prosthesis itself.
Complications related to implantation
There is a risk of complications from any type of surgical intervention, such as the consequences of anesthesia, infection, swelling, redness, bleeding, and pain. However, additional complications are possible during implantation.
Prosthesis collapse / rupture
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. Prosthesis collapse can occur both in the first months after surgery and several years after. The cause may be damage to the prosthesis during surgery with surgical instruments, capsule contracture, closed capsulotomy, external pressure (e. g. , trauma or strong chest compression, excessive compression during mammography), umbilical wound, as well. For unknown reasons.
We must remember 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.
Capsule contracture
The scar tissue or capsule that forms around the implant and compresses is called a capsular contracture. In most cases, the onset of capsule contracture is preceded by infection, hematoma, and seroma. Capsule contracture is more commonly seen when a prosthesis is placed under the pancreas. Typical symptoms are thickening and discomfort of the breast, pain, change in the shape of the breast, drop of the implant and / or movement.
In case of excessive compression and / or severe pain, surgical intervention is required to remove the capsule tissue or the implant itself and possibly replace it with a new one. However, this does not rule out the risk of recurrence of the capsule contracture.
Pain
Pain sensations of varying intensity and duration are possible after breast implant implantation. This pain occurs as a result of stretching of nerves or difficult contraction of muscles, which can be caused by improperly sized prostheses, poor placement, surgical errors, and capsular contractures. If severe pain appears, inform the attending physician.
Additional surgical intervention
After some time, surgery may be needed to replace or remove the prosthesis. In addition, prosthesis removal surgery may be required during prosthesis collapse, capsule contracture, infection, prosthesis displacement, and the emergence of calcium deposits. Most women, after removing an old prosthesis, put on a new one. Women who decide to opt for a new prosthesis implant should be prepared for the development of depressions and / or creases and other cosmetic defects.
Dissatisfaction with the cosmetic effect
The cosmetic effect of surgery may not always satisfy the patient. Possible wrinkles, asymmetry, implant displacement, incorrect size, unwanted shape, implant palpation, rough (irregular shape, raised) and / or very large or wide suture.
The likelihood of these defects can be reduced by careful planning of the operation and choosing the right equipment. However, even in this case, such a possibility is not completely ruled out.
Infection
Any surgical intervention is associated with a risk of infection. In most cases, the infection develops within a few days or weeks after surgery. If infection cannot be controlled with antibiotics and the presence of an implant complicates treatment, it may be necessary to remove the prosthesis. A new implant can be installed 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 rise in body temperature, vomiting, diarrhea, weakness, dizziness and / or rash. If these symptoms appear, you should contact your doctor immediately and start treatment.
Hematoma / Seroma
A hematoma is an accumulation of blood (in this case, around an implant or wound), while a seroma is an accumulation of serous fluid that is a component of blood water. Postoperative hematoma and seroma may contribute to infection and / or capsule contracture and may be accompanied by swelling, pain, and bruising. Hematoma formation is most likely in the postoperative period. However, it can appear at any time with a bruised breast. Typically, small hematomas and seromas resolve on their own. Large bruises or serums may require drainage. In some cases, a small scar remains after the drainage tube is removed. When inserting a drain, it is important not to damage the implant, which could cause the prosthesis to collapse / rupture.
Sensitivity changes in the breast and breast area
Sensitivity in the breast and breast area may change after prosthesis implantation. The changes are very different - from significant sensitivity to the absence of any sensation. These changes can be temporary and irreversible, affecting sexual sensitivity or breastfeeding ability.
Breastfeeding
So far, it has not been possible to obtain data from the prosthesis membrane to diffuse small amounts of silicone into the surrounding tissue and to enter breast milk. It is also unknown what effect silicone can have on the baby if it is taken with breast milk. Methods for determining the amount of silicon in breast milk are not currently available. However, a study comparing silicon levels in breast milk in women with and without prostheses suggests that women with salt-filled implants and gel prostheses have similar rates.
As for breastfeeding ability, according to the study, the proportion of women who could not breastfeed among women with implants was 64% versus 7% in women without implants. When a prosthesis is implanted through an areola incision, the ability to breastfeed is significantly reduced.
Calcium deposits in the tissue surrounding the implant
Calcium deposits on mammography may be mistaken for malignant tumors. In some cases, biopsy and / or surgical removal of the implant may be needed to differentiate them from the tumor.
Delayed wound healing
In some cases, wound healing can take a long time.
Rejection of the prosthesis
Insufficient thickness of the skin flap of the prosthesis and / or prolonged healing of the wound can lead to rejection of the prosthesis and it will appear clearly on the skin.
Necrosis
Necrosis, or tissue death around the prosthesis, can permanently deform scar tissue and interfere with wound healing. In such cases, surgical correction and / or removal of the prosthesis is necessary. Necrosis is often preceded by infection, use of steroids for surgical pocket cleaning, smoking, chemotherapy / radiotherapy, and intensive thermal and cold therapy.
Breast tissue atrophy / chest wall deformity
The pressure on the breast tissue by the prosthesis can be thinned and wrinkled. This can happen both with an implanted prosthesis and after its removal.
Other complications
Connective tissue diseases
Concerns about the placement of breast prostheses and the connection between autoimmune or connective tissue diseases such as lupus, scleroderma, or rheumatoid arthritis have arisen in a small number of women with breast prostheses following reports of this condition. However, the results of many large epidemiological studies that have examined women with breast prostheses and women who have never had breast surgery indicate that the incidence of similar diseases in women in both groups is approximately the same. Nevertheless, many women believe that it is the prosthesis that caused their illness. According to published data, arthroplasty does not increase the risk of developing breast cancer.