Factors to consider when deciding on breast augmentation
- Regardless of the operation (cosmetic or reconstructive), it should be borne in mind that this operation is not the last. After some 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 a shelf life, so they are not installed permanently. After some time, the prosthesis will have to be removed or replaced with a new one.
- Many of the changes that will happen to your breasts after prosthesis implantation will be irreversible. If you later decide to give up arthroplasty, you will be left with dents, wrinkles, wrinkles and other cosmetic defects.
Reduced efficiency of mammographic examinations
Endoprosthetics reduce the effectiveness of breast cancer diagnosis. The presence of a prosthesis should be reported to the examining physician in order to use special techniques to minimize the risk of rupture of the denture shell. In addition, additional scanning in different projections may be required, which increases the radiation dose that the woman receives. However, early detection of breast cancer justifies the associated risks.
Mammographic examination before surgery is recommended, and then 6-12 months after implant placement. The obtained images will allow further monitoring of changes that occur in the mammary glands.
Mammary gland self-examination
After implant placement, it is necessary to perform an independent examination of the mammary glands on a monthly basis. Ask your doctor to explain how to distinguish a prosthesis from breast tissue. If nodules or any suspicious changes are found, a biopsy should be performed. When doing this, be careful not to damage the implant.
Closed capsulotomy
Closed capsulotomy, which involves squeezing the fibrous tissue formed around the implant to rupture the capsule, is not recommended, as it may damage the prosthesis itself.
Implant-related complications
There is a risk of complications with any type of surgery, such as the effects of anesthesia, infection, swelling, redness, bleeding and pain. In addition, additional complications during implantation are possible.
Prosthesis collapse / rupture
If the integrity of the shell is compromised, the prosthesis may collapse. It can be instantaneous or gradual. From the outside 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 a few years. The reason may be damage to the prosthesis with surgical instruments during surgery, capsular contracture, closed capsulotomy, external pressure (eg trauma or intense chest compression, excessive compression during mammography), umbilical incision, and for unknown / unexplained reasons.
It should be borne in mind 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 a capsule that forms around the implant and compresses it is called a capsular contracture. In most cases, the development of capsular contracture is preceded by infection, hematoma and serum. Capsular contracture is more common when the prosthesis is placed under the pancreas. Typical symptoms are thickening and discomfort in the breast, pain, change in breast shape, bulging and / or shifting of the implant.
In case of excessive tightness 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 recurrence of capsular contracture.
Pain
After the implantation of a breast prosthesis, feelings of pain 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 improper sizing of dentures, poor placement, surgical errors and capsular contracture. If severe pain occurs, tell your doctor.
Additional surgical intervention
After some time, it may be necessary to perform surgery to replace or remove the prosthesis. In addition, prosthesis removal surgery may be required in case of prosthesis collapse, capsule contracture, infection, prosthesis displacement, and calcium deposits. Most women, after removing the old prosthesis, put on a new one. Women who decide to give up the implantation of a new prosthesis should be prepared for the fact that they will develop dents and / or wrinkles 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, irregular size, unwanted shape, palpability of the implant, rough (irregular shape, raised) and / or too large or wide suture.
The likelihood of these deficiencies 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 a risk of infection. In most cases, the infection develops within a few days or weeks after the operation. If the infection cannot be controlled with antibiotics, and the presence of implants makes treatment difficult, it may be necessary to remove the prosthesis. The installation of a new implant is possible only after recovery.
In rare cases, after the implantation of a breast prosthesis, toxic shock syndrome develops, which can be life-threatening. Symptoms include a sudden rise in body temperature, vomiting, diarrhea, fainting, dizziness and / or rash. If these symptoms occur, it is necessary to consult a doctor immediately and start treatment.
Hematoma / serum
Hematoma is an accumulation of blood (in this case around an implant or incision), and seroma is an accumulation of serous fluid, which is an aqueous component of blood. Postoperative hematoma and serum may contribute to infection and / or capsular contracture and be accompanied by swelling, pain, and bruising. Hematoma formation is most likely in the postoperative period. However, it can occur at any other time with bruising on the chest. As a rule, small hematomas and seromas pass on their own. Large bruises or seromas may require drainage. In some cases, a small scar remains after removing the drainage pipe. When inserting a drain, it is important not to damage the implant, which can lead to collapse / rupture of the prosthesis.
Changes in sensation in the nipple and breast area
After implant placement, the sensitivity in the nipple and breast area may change. The changes vary greatly - from significant sensitivity to the absence of any sensations. These changes can be temporary and irreversible, affecting sexual sensitivity or the ability to breastfeed.
Breastfeeding
Until now, it has not been possible to obtain data confirming the diffusion of small amounts of silicone from the prosthesis shell into the surrounding tissue and their entry into breast milk. It is also not known what effect silicone can have on the baby if it is ingested with breast milk. There are currently no methods for quantifying the amount of silicone in breast milk. However, a study comparing the silicone levels in breast milk of women with and without dentures suggests that women with saline-filled implants and women with gel dentures have similar rates.
Regarding the ability to breastfeed, according to the research, the share of women who cannot breastfeed among women with implants was 64% versus 7% among 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
On mammography, calcium deposits can be mistaken for malignant tumors. In order to differentiate 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.
Denture rejection
Insufficient thickness of the skin flap covering the prosthesis and / or prolonged wound healing can lead to rejection of the prosthesis, and this will be clearly seen through the skin.
Necrosis
Necrosis, ie the 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. Necrosis is often preceded by infection, use of steroids to clean the surgical pocket, smoking, chemotherapy / radiotherapy, and intensive thermal and cold therapy.
Breast tissue atrophy / chest wall deformity
The pressure that the prosthesis exerts on the breast tissue can thin out and wrinkle. This can happen with implants and after their removal without replacement.
Other complications
Connective tissue diseases
Concerns about the link between breast augmentation and the occurrence of autoimmune diseases or connective tissue diseases such as lupus, scleroderma or rheumatoid arthritis have emerged following reports of these conditions in a small number of women with breast prostheses. However, the results of numerous large epidemiological studies, which examined women with breast prostheses and women who have never had breast surgery, indicate that the frequency of such diseases in women in both groups is approximately the same. However, many women believe that dentures are the cause of their disease. According to published data, arthroplasty does not increase the risk of developing breast cancer.