Are you considering breast implants?
For many women, breast implants are a way to improve their confidence and self-esteem. Because it’s important to get your facts right, here is some of the most important information that you need to know.
- Although silicone breast implants are approved by the FDA and the TGA, there are a number of caveats. Breast implants are not lifetime devices. Because silicone implants can rupture without any signs or symptoms, it is recommended to have an MRI 3 years after the initial operation and every 2 years thereafter. This will cost several hundred dollars and is not covered by Medicare. Because the risk of rupture increases with time, many surgeons recommend that silicone implants be replaced every 10 years (although some patients with silicone gel implants have experienced rupture after only one year).
- The safest implants are saline implants. This is indisputable. With saline implants, because a rupture is readily detectable (the implant will deflate with the harmless release of the saline fluid) there are no recommendations for regular MRI examinations. In addition, saline implants have the lowest rate of capsule contracture and many women have had their saline implants for over 20 years without any requirement for replacement.
- Implants are best placed behind the chest muscles. When placed behind the muscle, the muscle acts as an additional covering to the implant which is especially important in thin women with little breast tissue. Placing the implant under the muscle prevents visible rippling and enables mammograms to be performed without interference. Placing the implant under the muscle produces a more natural slope to the breast and it is usually impossible to tell the difference between silicone and saline implants when they are place behind the muscle.
- When silicone implants leak it may not be possible to remove all of the silicone. This is because the silicone is absorbed into the capsule that formsaround the implants and also travels to the axillary lymph nodes. Although is some cases of capsular contracture, when the implant has been placed in front of the muscle, it may be possible to do a total “en-bloc capsulectomy” this is usually not the case when the implant has been placed behind the muscle. Because the capsule is adherent to the chest wall removal of the back part of the capsule could result in extensive damage to the chest wall and result in a pneumothorax (air in the chest).
- Breast augmentation can change nipple sensitivity. Because the nerves to the nipple enter the breasts from beneath the armpit these nerves can be stretched with a breast augmentation procedure (especially if the implants are large). This can result in changed nipple sensation in about 10% of patients. As nerve function returns there can be hypersensitivity and, although the majority of patients do not have altered nipple sensation after breast augmentation, in some women areas of permanent numbness can occur.
- Bigger is not always better. There is a size limit to your implants determined by the width of your chest. If you choose an implant wider than your chest then chances are it will protrude under your arms. In addition, an excessively large implant can cause stretching of the skin and so-called “bottoming out” where the implant descends on the chest wall giving the appearance of a nipple that sits too high.
- Women with textured implants are at risk of developing Anaplastic Large Cell Lymphoma (ALCL). Anaplastic Large Cell Lymphoma (ALCL) is a type of cancer that develops in the capsule around the breast implant. It occurs only with textured breast implants and is believed to be triggered by a bacterial infection. All anatomical implants have textured surfaces. The incidence of ALCL increases with the time that the implants have been in place and the risk appears to be between 1 in 1000 and 1 in 10.000. Therefore textured implants should rarely, if ever, be used and women with textured implants should have them replaced sooner rather than later. Learn more about breast implants here