What You Must Know
Breast enlargement is both safe and reliable. Complications, even minor, are very uncommon. This is worth repeating...
- Breast enlargement is both safe and reliable.
- Complications, even minor, are very uncommon.
Every procedure has its risks however and so does breast augmentation. As our consultation draws to a close in my office, I will review all pertinent risks of breast augmentation to ensure you are well informed before proceeding.
Most surgeons will not show you the following well established risks of augmentation on their websites for reasons that are difficult to understand. All medical procedures and medications come with their known risks. To illustrate my point, you may want to search the internet for the complications of common medications – like Tylenol (acetaminophen) for example. This medication is very safe and used by millions of people yet, if you take the time to inform yourself, you’ll see that even very safe products have their risks.
Will this is the same for breast augmentation. I’m not concerned that I’ll scare you with the following list of accepted risks. I’m much more worried about patients who ignore them.
So what issues might you encounter following breast augmentation?
It is possible, though unusual, to experience a bleeding episode during or after surgery. Should post-operative bleeding occur, it is usually noticed in the recovery room or sometime during the first day home. If it is large or uncomfortable, a return to the operating room may be required to drain the accumulated blood (hematoma).
Infection is very unusual following breast augmentation. When it appears, it is usually in the immediate post operative period. You may notice some redness and tenderness near your incision and surrounding breast. If this occurs, you will be treated with antibiotics. In severe cases, the implant may need to be removed under a light general anesthesia in order for the infection to heal. A new implant can then be reinserted about 3 or 4 months later and the same aesthetic results are expected.
When an implant is inserted into the breast, your body naturally forms a scar around it much like your body would form a scar around a foreign body like a sliver of wood. When if forms around a breast implant, we call this a capsule. If the capsule contracts, it can tighten and make the breast round, firm, and possibly painful. Excessive firmness of the breasts can occur soon after surgery or years later. Although the occurrence of symptomatic capsular contracture is not predictable, it generally occurs in less than 10-15 percent of patients. The incidence of symptomatic capsular contracture can be expected to increase over time. Capsular contracture may occur on one side, both sides or not at all. Capsular contracture is minimized with a healthy regime of massaging your breasts following augmentation. In severe cases, patients may require a release of this tightness – called an open capsulotomy – under a light general anesthetic.
Change in Nipple and Skin Sensation
Some change in nipple sensation is not unusual right after surgery. After several months, most patients have normal sensation. Partial or permanent loss of nipple and skin sensation may occur occasionally.
Excessive scarring is uncommon. In rare cases, abnormal scars may result. Scars may be unattractive and of different color than surrounding skin. A revision of your scars may be required and is usually performed under local anesthesia.
Breast implants, similar to other medical devices, can fail. Implants can break or leak. When a saline-filled implant deflates, its salt water filling will be absorbed by the body. When a silicone implant ruptures, the silicone gel will accumulate in the space between the implant and the capsule around it. This may lead to a capsular contracture resulting in firmness of the implant. Should such a problem occur, it is recommended the implant and its capsule be removed and replaced. Rupture can occur as a result of an injury, from no apparent cause, or during mammography. It is possible to damage an implant at the time of surgery. Damaged or broken implants cannot be repaired. Ruptured or deflated implants require replacement or removal. While the implants we use are guaranteed for life, many surgeons feel that breast implants cannot be expected to last forever. You should expect that perhaps once in your lifetime you will need to have them replaced. I do not feel that you need to schedule a change of implants in 10-15 years following surgery as some surgeons suggest.
Lack of adequate tissue coverage or infection may result in exposure and extrusion of the implant. Skin breakdown has been reported with the use of steroid drugs or after radiation therapy to breast tissue. If tissue breakdown occurs and the implant becomes exposed, implant removal may be necessary. Once the area is healed, a new implant can usually be reinserted 3 to 4 months later.
Breast implants may make mammography more difficult and may obscure the detection of breast cancer. Implant rupture can occur from breast compression during mammography but this is very rare. You will need to inform your mammography technologist of the presence of breast implants so that appropriate mammogram studies may be obtained. Patients with capsular contracture may find mammogram techniques painful and the difficulty of breast imaging will increase with the extent of contracture. Ultrasound, specialized mammography and MRI studies may be of benefit to evaluate breast lumps and the condition of the implant(s).
Skin Wrinkling and Rippling
Visible and palpable wrinkling of implants can occur. Some wrinkling is normal and expected. This may be more pronounced in patients who have saline-filled implants or thin breast tissue. It may be possible to feel the implant valve on saline implants. Some patients may find palpable valve and wrinkles cosmetically undesirable.
Pregnancy and Breast Feeding
Although many women with breast implants have successfully breast fed their babies, it is not known if there are increased risks in nursing for a woman with breast implants or if the children of women with breast implants are more likely to have health problems. There is insufficient evidence regarding the absolute safety of breast implants in relation of fertility, pregnancy or breast feeding. Very limited research has been conducted in this area and at this time there is no scientific evidence that this is a problem.
Calcium deposits can form in the scar tissue surrounding the implant and may cause pain, firmness, and can be visible on mammography. This issue was more commonly seen with older silicone implants that were known to slowly leak small amounts of silicone gel into the space between the implant and the capsule. In some cases these deposits should be investigated to differentiate them from the calcium deposits sometimes seen with breast cancer. Should this occur, additional surgery may be necessary to remove and examine the calcifications.
Displacement or migration of a breast implant may occur from its initial placement and can be accompanied by discomfort and/or distortion in breast shape. If this is noticeable, another surgery may be necessary to correct this problem.
In rare cases, local allergies to tape, suture material, or topical preparations have been reported. Systemic reactions which are more serious may result from drugs used during surgery and prescription medicines. Allergic reactions may require additional treatment.
Current medical information does not demonstrate an increased risk of breast disease or breast cancer in women who have breast implant surgery for either cosmetic or reconstructive purposes. Breast disease can occur independently of breast implants. It is recommended that all women perform periodic self examination of their breasts, have mammography according to Canadian Cancer Society guidelines, and seek professional care should they notice a breast lump. There are no published studies showing that women with breast implants have more breast cancer, more aggressive breast cancer or more advance breast cancer at the time of detection as compared to the normal population.
Fluid may accumulate around the implant following surgery, trauma or vigorous exercise. Additional treatment may be necessary to drain fluid accumulation around breast implants.
Long Term Results
Subsequent alterations in breast shape may occur as the result of aging, weight loss or gain, pregnancy, or other circumstances not related to augmentation mammaplasty. Having implants does not mean your breasts will not droop or sag with age.
Thrombosed veins, which resemble cords occasionally develop in the area of the breast and resolve without medical or surgical treatment.
Immune System Diseases and Unknown Risks
Some women with breast implants have reported symptoms similar to those of known diseases of the immune system, such as systemic lupus erythematosis, rheumatoid arthritis, scleroderma, and other arthritis-like conditions. To date, there is no scientific evidence that women with either silicone gel-filled or saline-filled breast implants have an increased risk of these diseases.
You may be disappointed with the results of surgery. Asymmetry in implant placement, breast shape and size may occur after surgery. Unsatisfactory surgical scar location or displacement of the implant may occur. Pain may occur following surgery. It may be necessary to perform additional surgery to improve your results.
Removal/Replacement of Breast Implants
Future removal or replacement of breast implants and the surrounding scar tissue envelope involves a surgical procedure with risks and potential complications.
Additional Surgery Necessary
Should complications occur, additional surgery or other treatments may be necessary.
Even though risks and complications occur infrequently, the risks I have just listed above are particularly associated with breast augmentation. Other complications and risks can occur but are even more uncommon. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee or warranty expressed or implied on the results that may be obtained from having breast augmentation.
Any other questions regarding the risks of breast augmentation can be answered by Dr. Zelt when you set up your consultation.