Factors to consider when deciding on breast augmentation
- No matter what type of surgery we are talking about (aesthetic or reconstructive), it should be remembered that this operation is not the last. After a certain time, additional surgical intervention will be required. In addition, you will need to visit your doctor regularly throughout your life.
- Contrary to popular belief, breast prostheses have an expiration date, so they are not installed permanently. After a certain time, the prosthesis will need to 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 later decide to abandon arthroplasty, you will be left with depressions, folds, wrinkles and other cosmetic defects.
Reducing the effectiveness of mammographic examinations
Endoprosthetics reduce 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 minimize the risk of rupture of the prosthesis shell. In addition, additional scanning may be required in different projections, which increases the radiation dose a woman receives. However, early detection of breast cancer justifies the associated risks.
It is recommended to undergo a mammographic examination on the eve of surgery and then 6-12 months after 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 implant installation, it is necessary to perform an independent examination of the mammary glands on a monthly basis. Ask your doctor to explain how to distinguish 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 is not recommended, which involves squeezing the fibrous tissue formed around the implant in order to rupture the capsule, as it may 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 compromised, the prosthesis may collapse. It can be immediate or gradual. From the outside, 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 after several years. The reason may be damage to the prosthesis by surgical instruments during surgery, capsular contractures, closed capsulotomy, external pressure (for example, with trauma or intense chest compression, excessive compression during mammography), with an umbilical incision, as well asunknown / unexplained reasons.
It should be remembered that the prosthesis wears out over time, which can lead to its rupture / collapse. An additional operation 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 a capsular contracture. In most cases, the onset of capsular contracture is preceded by infection, hematoma, and seroma. Capsular contracture is most often seen when the prosthesis is placed under the pancreas. Typical symptoms are thickening and tightness of the breast, pain, change in the shape of the breast, elongation and / or displacement of the implant.
In case of excessive compression and / or severe pain, surgery is needed 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 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 nerve tightening or difficult muscle contraction, which can be caused by prostheses of improper size, poor placement, surgical errors, and capsular contractions. If severe pain occurs, tell the attending physician.
Additional surgical intervention
After a certain time, it may be necessary to perform a surgical intervention to replace or remove the prosthesis. In addition, prosthesis removal surgery 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, put on 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 surgery may not always satisfy the patient. Possible wrinkles, asymmetry, implant displacement, incorrect size, unwanted shape, implant touch, rough (irregularly shaped, 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.
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 complicates treatment, removal of the prosthesis may be necessary. Installation of a new implant is only possible 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, fainting, dizziness and / or redness. If these symptoms occur, you should immediately consult a doctor and start treatment.
Hematoma / seroma
A hematoma is a collection of blood (in this case, around an implant or incision), and a seroma is a collection of serous fluid, which is the aqueous component of blood. Hematoma and postoperative seroma may contribute to infection and / or capsular contracture and be associated with 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 bruised chest. As a rule, small hematomas and seromas resolve themselves. Large bruises or serums may require drainage. In some cases, after removing the drainage tube, a small scar is left. When inserting a drain, it is important not to damage the implant, which can lead to the prosthesis collapsing / rupturing.
Sensitivity changes in the nipple and chest area
After implantation of the prosthesis, the sensitivity in the nipple and chest area may change. The changes vary greatly - from significant sensitivity to the absence of any sensation. These changes can be temporary and irreversible, affecting sexual sensitivity or the ability to breastfeed.
Breastfeeding
So far no data has been obtained confirming the diffusion of small amounts of silicon from the prosthesis shell into the surrounding tissues and their insertion 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 determine the amount of silicon in breast milk. However, a study comparing the level of silicon in breast milk of women with and without prostheses suggests that women with salt-filled implants and women with gel prostheses have similar rates.
In terms of ability to breastfeed, 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 incision of the areola, the ability to breastfeed is significantly reduced.
Calcium deposits in the tissues surrounding the implant
On mammography, calcium deposits can be confused with malignant tumors. To distinguish 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.
Rejection of the prosthesis
Insufficient thickness of the skin covering the prosthesis and / or prolonged wound healing may lead to rejection of the prosthesis and will be clearly visible through the skin.
Necrosis
Necrosis, or death of the tissue around the prosthesis, can permanently deform the 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, the use of steroids for surgical pocket cleansing, smoking, chemotherapy / radiotherapy, and intensive thermal and cold therapy.
Breast tissue atrophy / deformity of the chest wall
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 link 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. However, the results of a number of large epidemiological studies, which have examined 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 approximately the same. However, many women believe it was the prosthesis that caused their disease. According to published data, arthroplasty does not increase the risk of developing breast cancer.