Factors To Consider When Deciding For Breast Augmentation
- Regardless of what type of operation we are talking about (cosmetic or reconstructive), it should be remembered that this operation will not be the last. After a certain period of time, additional surgical intervention is required. In addition, you will need to see a doctor regularly throughout your life.
- Contrary to popular belief, breast prostheses have an expiration date and are therefore not used permanently. After a certain period of time, the prosthesis must be removed or replaced with a new one.
- Many changes that occur in your breasts after the prosthesis is inserted are irreversible. If you later decide to abandon the endoprosthetics, pits, folds, fine lines, and other cosmetic defects will be left behind.
Decreased effectiveness of mammography exams
Endoprosthetics reduce the effectiveness of breast cancer diagnostics. It is necessary to inform the examining doctor of the presence of the prosthesis so that he can use special techniques to minimize the risk of breaking the prosthetic shell. In addition, additional scanning in different projections may be required, which increases the dose of radiation a woman receives. However, early detection of breast cancer justifies the risks involved.
It is recommended to undergo a mammography exam the evening before surgery and then 6-12 months after the implant is inserted. The images obtained will make it possible to follow the changes in the mammary glands further.
Self-examination of the mammary glands
After inserting the implant, it is necessary to conduct an independent examination of the mammary glands every month. Ask your doctor to explain the difference between a prosthesis and breast tissue. If lumps or suspicious changes are found, a biopsy should be performed. Be careful not to damage the implant.
Closed capsulotomy
A closed capsulotomy, which involves squeezing the fibrous tissue around the implant to tear the capsule, is not recommended as it can damage the prosthesis itself.
Complications related to the implantation
With any type of surgery, there is a risk of complications such as: B. the effects of anesthesia, infection, swelling, redness, bleeding and pain. In addition, additional complications are possible with the implantation.
Collapse / breakage of the prosthesis
If the integrity of the shell is violated, the prosthesis can collapse. It can be instantaneous or gradual. Outwardly, it looks like a change in the size or shape of the breast. The breakdown of the prosthesis can occur both in the first months after the operation and after several years. Causes can be damage to the prosthesis by surgical instruments during the operation, capsular contracture, closed capsulotomy, external pressure (e. g. for unknown / unexplained reasons.
It should be noted that the prosthesis will wear out over time, which can lead to its breakage / collapse. Additional surgery is required to remove the resting prosthesis and insert a new one.
Capsular contracture
Scar tissue or a capsule that forms around the implant and compresses it is called a capsular contracture. In most cases, infection, bruises, and seromas precede the onset of capsular contracture. Capsular contractures are seen more often 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.
If there is 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 capsular contracture recurring.
pains
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 that can be caused by improperly sized prostheses, poor placement, surgical errors, and capsular contractures. Notify the attending physician in the event of severe pain.
Additional surgical intervention
After a period of time, surgery may be necessary to replace or remove the prosthesis. In addition, surgery to remove the prosthesis may be required if the prosthesis collapses, capsular contracture, infection, displacement of the prosthesis, and the appearance of calcium deposits. Most women install a new one after removing the old prosthesis. Women who decide not to have a new prosthesis implanted should be prepared to develop depression and / or wrinkles and other cosmetic defects.
Dissatisfaction with the cosmetic effect
The cosmetic effect of the operation cannot always satisfy the patient. Possible folds, asymmetry, implant displacement, wrong size, undesired shape, palpability of the implant, rough (irregularly shaped, raised) and / or too large or wide seam.
Careful planning of the surgery and choosing the right technique can reduce the likelihood of these defects. But even in this case, such a possibility cannot be completely ruled out.
infection
Any surgical procedure 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. The installation of a new implant is only possible after recovery.
In rare cases, a 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 you experience these symptoms, you should immediately seek medical advice and start treatment.
Hematoma / seroma
A hematoma is a build-up of blood (in this case, around an implant or a cut) and a seroma is a build-up of serous fluid, which is the watery component of blood. Postoperative bruises and seromas can contribute to infection and / or capsular contractures and be accompanied by swelling, pain, and bruising. The formation of a hematoma is most likely in the postoperative period. However, it can occur at any other time with a bruised chest. Small bruises and seromas usually 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, care must be taken that the implant is not damaged, which can lead to the collapse / breakage of the prosthesis.
Changes in sensation in the nipple and breast area
After implantation of the prosthesis, the sensitivity in the nipple and breast area can change. The changes vary widely - from significant sensitivity to the absence of any sensation. These changes can be temporary and irreversible and affect sexual sensitivity or the ability to breastfeed.
Breastfeeding
So far, no data has been collected that confirm the diffusion of small amounts of silicone from the prosthesis shell into the surrounding tissue and its entry into breast milk. It is also unknown what effects silicone can have on a baby when ingested with breast milk. There are currently no methods to quantify the amount of silicone in breast milk. However, a study comparing the silicone content 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, the proportion of women who could not breastfeed among women with implants was 64% compared to 7% among women without implants. If the prosthesis is implanted through the areola incision, the ability to breastfeed is significantly reduced.
Calcium deposits in the tissue around the implant
In mammography, calcium deposits can be mistaken for malignant tumors. In some cases, a biopsy and / or surgical removal of the implant may be required to distinguish them from cancerous growths.
Delayed wound healing
In some cases, the cut can take a long time to heal.
Rejection of the prosthesis
Too small a thickness of the skin flap covering the prosthesis and / or prolonged wound healing can lead to rejection of the prosthesis and it will clearly shine through the skin.
necrosis
Necrosis or tissue death around the prosthesis can permanently deform scar tissue and prevent wound healing. In such cases, surgical correction and / or removal of the prosthesis must be resorted to. The necrosis is often 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 deformity
The pressure that the prosthesis exerts on the breast tissue can become thinner and wrinkled. This can happen both with an implanted prosthesis and after it has been removed without replacement.
Other complications
Connective tissue diseases
Concerns about the association between breast prosthesis placement and the occurrence of autoimmune or connective tissue diseases such as lupus, scleroderma or rheumatoid arthritis emerged after these conditions were reported in a small number of women with breast prostheses. However, the results of a number of large epidemiological studies examining women with breast prostheses and women without breast surgery show that the incidence of such diseases in women is roughly the same in both groups. Even so, many women believe that it was the prosthesis that caused their disease. According to published data, endoprosthetics do not increase the risk of developing breast cancer.