Factors to consider when deciding on breast augmentation
- Regardless of the operation (cosmetic or reconstructive), it is important to remember that this operation is not the last. Additional surgery will be required after some time. In addition, you will need to see your doctor regularly throughout your life.
- Contrary to popular belief, breast prostheses have a lifespan, so they are not permanently installed. After some time, the prosthesis will have to be removed or replaced with a new one.
- Many changes that will occur in your breasts after the prosthesis is placed will be irreversible. If you later decide to give up arthroplasty, you will have depressions, wrinkles, wrinkles and other cosmetic defects.
Decreased effectiveness of mammography examinations
Reduces the effectiveness of endoprosthetic breast cancer diagnosis. The examining physician should be informed of the availability of the prosthesis so that he or she can use special methods to minimize the risk of rupture of the prosthesis shell. In addition, different projections may require additional screening, which increases the radiation dose a woman receives. However, early detection of breast cancer justifies the associated risks.
It is recommended to have a mammogram before the operation and then 6-12 months after the implant is placed. The obtained images will allow you to further monitor the changes in the mammary glands.
Self-examination of the mammary glands
An independent mammogram should be performed monthly after implant placement. Ask your doctor to explain the difference between a prosthesis and breast tissue. If fragments or any suspicious changes are found, a biopsy should be performed. Be careful not to damage the implant.
Closed capsulotomy
A closed capsulotomy involving compression of the fibrous tissue formed around the implant to rupture the capsule is not recommended, as it may damage the prosthesis itself.
Complications associated with implantation
There is a risk of complications in any surgery, such as anesthesia, infection, swelling, redness, bleeding and the effects of pain. However, additional complications are possible during implantation.
Prosthesis collapse / rupture
If the integrity of the shell is compromised, the prosthesis may collapse. It can be sudden or gradual. Externally, 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 several years later. The cause may be damage to the prosthesis with surgical instruments during surgery, capsule contracture, closed capsulotomy, external pressure (eg, trauma to the chest or tight compression, excessive compression during mammography), umbilical cord incision, as well as damage to the prosthesis. for unknown / unexplained reasons.
Keep in mind that the prosthesis wears out over time, which can cause it to break / collapse. Additional surgery is required to remove the prosthesis and insert a new one.
Capsule contracture
The scar tissue or capsule that forms around the implant and compresses it is called a capsule contracture. In most cases, the onset of capsule contracture is accompanied by infection, hematoma, and seroma. Capsule contracture is more common when the prosthesis is placed under the pancreas. Typical symptoms include thickening and discomfort of the mammary glands, pain, breast reshaping, implant removal, and / or displacement.
In case of excessive compression and / or severe pain, surgery is required to remove the capsule tissue or the implant itself and possibly replace it with a new one. However, this does not eliminate the risk of recurrence of capsule contracture.
Pain
Pain of varying intensity and duration is possible after implantation of a breast prosthesis. This pain can occur as a result of compressed nerves or difficult muscle contractions, which can be caused by improperly sized prostheses, improper placement, surgical errors, and capsule contractures. If severe pain occurs, inform the attending physician.
Additional surgical intervention
After a certain period of time, surgery may be needed to replace or remove the prosthesis. In addition, surgery may be required to remove the prosthesis during prosthesis collapse, capsule contracture, infection, prosthesis displacement, and the appearance of calcium deposits. Most women wear a new prosthesis after removing it. Women who decide to refuse implantation of a new prosthesis should be prepared for the fact that they will develop depression and / or wrinkles and other cosmetic defects.
Dissatisfaction with the cosmetic effect
The cosmetic effect of the operation may not always satisfy the patient. Possible wrinkles, asymmetry, implant displacement, incorrect size, undesirable shape, implant palpation, rough (irregularly shaped, raised) and / or very large or wide suture.
Careful planning of the operation and selection of the right technique can reduce the likelihood of these defects. But even in this case, such a possibility can not 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 surgery. If the infection cannot be controlled with antibiotics and the presence of an implant makes treatment difficult, a prosthesis may need to be removed. Installation of a new implant is possible only after recovery.
Rarely, toxic shock syndrome develops after implantation of a life-threatening breast prosthesis. Symptoms include a sudden increase in body temperature, vomiting, diarrhea, fainting, dizziness, and / or rash. If these symptoms appear, you should see a doctor immediately 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 that is an aqueous component of blood. Postoperative hematoma and seroma may cause infection and / or capsule contracture and may be accompanied by swelling, pain, and bruising. Hematoma is most likely to occur in the postoperative period. However, it can be seen by squeezing the chest at any other time. As a rule, small hematomas and seromas resolve on their own. Large bruises or seromas may require drainage. In some cases, a small scar remains after the drain pipe is removed. It is important not to damage the implant when placing the drain, which can cause the prosthesis to collapse / rupture.
Changes felt in the nipple and breast area
Sensitivity in the nipple and breast area may change after prosthesis implantation. The changes vary widely - 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
So far, it has not been possible to obtain information from the prosthetic shell that small amounts of silicone have spread to surrounding tissues and entered breast milk. It is not known how breastfeeding will affect the baby. Currently, there is no way to measure the amount of silicone in breast milk. However, a study comparing the level of silicone in breast milk of prosthetic and non-prosthetic women shows that women with saline-filled implants and gel prostheses have similar proportions.
In terms of breastfeeding ability, according to the survey, the proportion of women who are unable to breastfeed among implanted women was 64%, compared to 7% among women who did not have implants. When a prosthesis is implanted in an areola, 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 some cases, a biopsy and / or surgical removal of the implant may be required to differentiate them from cancerous growths.
Delayed wound healing
In some cases, the cuts may take a long time to heal.
Refusal of prosthesis
Insufficient thickness of the skin cover covering the prosthesis and / or prolonged healing of wounds can lead to rejection of the prosthesis, which will manifest itself clearly through the skin.
Necrosis
Necrosis or tissue death around the prosthesis can permanently deform the scar tissue and prevent wound healing. In such cases, surgical correction and / or removal of the prosthesis should be considered. Often before necrosis, infection, the use of steroids to clean the surgical pocket, smoking, chemotherapy / radiotherapy, and intensive heat and cold therapy are performed.
Atrophy of breast tissue / deformation of the chest wall
The pressure the prosthesis puts on the breast tissue can become thinner and wrinkled. This can occur both with an implanted prosthesis and after removal without replacement.
Other complications
Connective tissue diseases
Concerns about the relationship between breast implant placement and the occurrence of autoimmune or connective tissue diseases such as lupus, scleroderma, or rheumatoid arthritis have been reported in a small number of women with breast prostheses. However, the results of a number of large epidemiological studies of women with breast prostheses and women who have never had breast surgery show that the incidence of such diseases is approximately the same among women in both groups. However, many women believe that the cause of the disease is a prosthesis. According to published data, arthroplasty does not increase the risk of developing breast cancer.