Breast augmentation is the most commonly performed cosmetic surgical procedure in the United States and therefore the most commonly performed breast plastic surgery. Today it’s important to be fully informed about all the risks and complications that you might encounter with breast plastic surgery. Of all the breast plastic surgery procedures performed in 2006 in the United States, 329,000 were for breast augmentations.
The first woman implanted with silicone implants was in 1962. There are two primary types of breast implants: saline-filled and silicone-gel-filled implants. It was predominantly silicone implants that were designed in the 1970s that were involved in the class-action lawsuits against Dow-Corning and many other manufacturers in the early 1990s.
There have been several types of breast implants developed other than the two most common, saline filled and silicone gel filled, including polypropylene string and soy oil, but these are not commonly used, if at all; leakage of oil into the body during a rupture would not be good. Dr. Thomas Cronin and Dr. Frank Gerow, two Houston, Texas, plastic surgeons, developed the first silicone breast prosthesis with the Dow Corning Corporation in back in 1961. For women with very little breast tissue, or for post-mastectomy reconstruction, plastic surgeons believe that silicone gel implants are the superior device; but in patients with more breast tissue, saline implants can look very similar to silicone gel implants.
Saline implant shells are made of silicone elastomer and the implants are filled with saline solution after the implant is placed in the body. One manufacturer did produce a model of pre-filled saline implants but has been reported to have had high failure rates following surgery.
When breast implants are removed that have been implanted for a long period of time, a mastopexy is often performed to tighten up the loose skin: this is additional surgery usually done at the same time and at an additional expense. It’s important to remember that breast implants don’t last a lifetime and at some time or other would need to be removed or removed permanently and replaced. Extracapsular silicone has the potential to migrate to other parts of the body, but most clinical complications have appeared to be limited to the breast and axillae as inflammatory nodules (granulomas) and enlarged lymph glands in the armpit area called axillary lymphadenopathy.
Studies of saline-filled breast implants approved by the FDA in May 2000 showed rupture and deflation rates of 3-5% at three years and 7-10% at five years for breast augmentation patients. One study reported that only 30% of ruptures in asymptomatic patients are accurately detected by experienced plastic surgeons, compared to 86% detected by MRI. Some studies have suggested that subjective and objective symptoms of women with breast implants may improve partially or entirely when their implants are removed.
Since the early 1990s, a number of independent reviewers have examined studies concerning links between silicone gel breast implants and systemic diseases; the consensus of these reviews is that there is no clear evidence of a causal link between the implantation of silicone breast implants in breast plastic surgery and systemic disease; it’s always wondered who is funding these studies and that should clearly be stated. Capsules of tightly-woven collagen fibers form as an immune response around a foreign body like breast implants, which tends to wall it off; capsular contracture happens when the capsule tightens and squeezes the implant.
The risk and treatment of extracapsular silicone gel is still controversial; plastic surgeons agree that it’s difficult to remove, but there is disagreement about the lasting health effects. Local complications that can occur with breast implants include post-operative bleeding, fluid collections, surgical site infection, breast pain, alterations in nipple sensation, interference with breast feeding, visible wrinkling, asymmetric appearance, wound dehiscence with potential implant exposure, thinning of the breast tissue, and disruption of the natural plane between the breasts.
Although the general international consensus is that silicone implants in breast plastic surgery has not been shown to cause systemic illness, one must keep in mind that many women have reported a connection to symptoms they are having and to their breast augmentation. Make sure to do plenty of research online and offline before you make a decision about any breast plastic surgery including breast augmentation. The surgical procedure for breast augmentation takes approximately one to two hours, but the lasting effects of breast plastic surgery, both good and bad, will be around for a few years.