"Everything you need to know about Breast Implants"

Breast Implants

The following is information I was able to find on-line regarding the surgery that I went through. Hopefully, it will answer some of your questions.

During breast implant surgery, a breast implant is placed under the breast tissue or under the chest muscle beneath the breast. A breast implant is a soft silicone shell filled with a saline (saltwater) solution or another substance. Saline solution is now the material most commonly used to fill breast implants because it can be safely absorbed by the body if the implant leaks or ruptures.

To position the breast implant, an incision is made in the bottom crease of the breast, the armpit, or along the lower edge of the areola (the colored area surrounding the nipple). The breast implant is inserted through the incision and may be placed under either the breast tissue or the chest muscle beneath the breast. Some doctors believe that putting the breast implant beneath the chest muscle lowers the risk for capsular contracture and interferes less with mammography than when the breast implant is under the breast tissue but in front of the muscle. (See the Breast Implant Risks section below for more information.) Once the breast implant has been carefully adjusted to the correct shape and position, the incision is closed with stitches.

A breast lift (mastopexy) may be done at the same time as the breast augmentation. To lift the breasts, excess skin from the bottom of the breast and the area around the areola is removed. The remaining skin is then brought together, which tightens and raises the breast. A breast lift requires larger incisions than breast augmentation. Incisions may extend from the areola down to the crease where the bottom of the breast meets the chest.

Breast augmentation and breast lifts are usually done as outpatient procedures in a hospital or outpatient surgery center.

What to Expect After Breast Augmentation Surgery

Immediately after the breast implant surgery, gauze is taped over the stitched incisions, and the breasts are wrapped in an elastic bandage or supported by a special bra. The stitches may be removed in 7 to 10 days.

Most women have some swelling, bruising, and soreness in their breasts for several days after the breast augmentation procedure. Medication can help relieve the pain. Swelling and bruising may last for several weeks. Some women also have a burning sensation in their nipples right after surgery. Wearing a supportive bra can help reduce swelling and support the breasts while they heal.

Most women can resume normal work and social activities within a few days, unless those activities involve heavy lifting or strenuous exercise. Your doctor will tell you when you can return to these activities.

You will have scars after breast implant surgery, but these are usually in well-concealed areas. These procedures are designed to minimize scarring so that incisions are not easily detected. Scars usually fade after several months. Having a breast lift in addition to an enlargement leaves larger, more visible scars.

Breast Implant Surgery - Why It Is Done

Breast implant surgery is done to increase the size of the breasts and enhance the shape of the breast. A woman may decide to get breast implants to:

• Enhancing breasts that are considered too small.
• Restore the size or shape of the breasts after significant weight loss or pregnancy. A breast lift may be done at the same time as the breast augmentation.
• Make the breasts more evenly proportioned. In many women, one breast may be larger or sit higher than the other.
• Breast implants may also be used to reconstruct breasts after surgery for breast cancer (mastectomy).

How Well Does Breast Implant Surgery Work?

Breast implant surgery can increase a woman's breast size by one or more bra cup sizes. It can also reduce differences in size and shape between a woman's breasts. Studies have shown that most women who get breast implants are very happy with the results.

Breast implants will not prevent the breasts from sagging as a result of future pregnancy or weight gain or as a natural result of aging.

Risks Involved with Breast Implants

The risks of getting breast implants include:

• Capsular contracture. One of the most common problems caused by breast implants, this condition occurs when scar tissue around the breast implant hardens and begins to squeeze the breast implant. It can cause hardening of the breast tissue, rippling in the skin of the breast, and changes in the shape of the breast. It may also be painful. Surgery is sometimes needed to remove the scar tissue or replace the breast implant(s) when capsular contracture develops.
• Loss of feeling. This can occur in the nipples or breast tissue due to nerve damage. Often this is temporary, but it may be permanent in some women.
• Differing Size & Shape. Differences in size or shape of the breasts after surgery.
• Changes in the implant. Normal activity or an injury to the breast can damage the breast implant, causing it to leak, deflate, or rupture. Over time, the breast implant may harden, develop ripples, shift position, or change shape. Surgery may be needed to remove the breast implant and replace it (if desired) if any of these changes occur.
• Infection (not common). This can occur at any time, but it typically occurs during the first week after breast augmentation surgery. In some cases of infection, the implant may have to be removed for several months and then replaced.
• Bleeding. Blood collection under the skin, or hematoma. This is uncommon.
• Scaring. Abnormal scarring. This is uncommon.
• Breast Cancer. An important problem associated with breast implants is that they may make breast cancer harder to detect on a mammogram. See the What to Think About - Breast Augmentation section below for more information about this important issue.

What to Think About - Breast Implants

You are likely to be happy with the results if you have clear, realistic expectations about the surgery and share these with your doctor. Breast implants will make your breasts larger and perhaps give them a shape you are more pleased with, but no surgeon can guarantee perfection.

Also keep in mind that:

• Breast augmentation and lifts do not prevent changes in the breast that occur as a result of future pregnancies, weight gain or loss, or the force of gravity over time.
• Breast implants may later need to be surgically removed or replaced if they leak, rupture, wrinkle, change shape, or develop other problems.
• Some of the changes in the breast tissue and skin caused by breast implants are permanent. If you later have the breast implants removed, the breasts may have permanent wrinkles, dimples, or other changes.
• Some studies suggest that breast implants may affect a woman's ability to breast-feed, but this has not been proven.
• Health insurance will not cover the cost of breast implants unless they are being used as part of breast reconstruction after surgery for breast cancer. Likewise, health insurance will not cover the costs of breast augmentation surgery complications that arise during or after surgery or for future surgeries to remove or replace the breast implants.

Breast Cancer Screening (Mammography) after Breast Implant Surgery

A breast implant can hide abnormal breast tissue or lesions, making detection of abnormal or cancerous breast tissue during mammography more difficult. To produce accurate, high-quality images, the breast has to be squeezed fairly tightly. Rarely, this causes a breast implant to leak or rupture. Also, scarring and calcium deposits around the breast implant may look like cancerous tissue and make the mammogram harder to interpret.

Breast Implants: Controversy over breast implant safety

Saline-filled breast implants are considered safe and are the most commonly used breast implant today. Saline solution can be safely absorbed by the body if the breast implant leaks or ruptures. Although silicone gel implants may offer a better, more natural-looking cosmetic result, continuing concern over their safety in the event of a leak or rupture means that most plastic surgeons avoid using silicone implants on a routine basis.

search phrases: breast augmentation, breast implants, breast enlargement

reference: Janowsky EC, et al. (2000). Meta-analyses of the relation between silicone breast implants and the risk of connective-tissue diseases. New England Journal of Medicine, 342: 781–790.

referral service: plastic surgery, breast augmentation, & breast implants