New York Breast Expert: Breast Enlargement Risks
RISKS
There are several risks associated with breast enlargement. Remember that a
risk is something that the surgeon cannot control, so misplacement of the implant,
for example, is not a risk. It is a mistake. If your prospective surgeon does
not describe all the risks of the surgery, do not let him operate on you. Find
someone else.
1) Infection: I give antibiotics right after the surgery to attempt to prevent
an infection from occurring. Infection in my personal experience is very rare
-- about one in one thousand operations; however, should an infection occur,
the implants might have to be removed. They would be replaced later on at no
extra charge.
2) Bleeding: Bleeding after the surgery is also very unusual, about one in
one hundred patients. It is not life threatening. This can happen because a
small blood vessel can open up a few hours after the surgery and begin to ooze.
The breast would swell a great deal and become quite painful. It would necessitate
returning to the operating room to stop the bleeding. I emphasize that it is
not a dangerous condition, only something that needs to be taken care of.
3) Hardness of the breast: The most common problem with breast augmentation
is that the breasts might not feel natural. This can happen because your body
makes a covering around the implant, sort of like a scar, that is referred to
as a capsule. This is the way the body walls off an object that is foreign to
it. (Silicone has the property that it cannot be rejected, so in a sense, it
is just isolated). If you form a thin capsule around the implant, your breasts
will feel soft. Unfortunately, if your body makes a thick capsule, it can squeeze
the implant and then it will feel hard. This is called capsular contracture.
(Think of it as a balloon not quite filled with water that you then squeeze--it
feels hard.) The problem does not cause illness, it is simply unaesthetic. It
can be remedied in most cases with a procedure called a closed capsulotomy.
To accomplish this, the doctor will squeeze your breast very hard to break the
capsule. (It is almost impossible to break the implant.) Breaking the capsule
alleviates the contracting effect and allows the space around the implant to
expand making the breast feel soft again. This could recur again. The overall
risk in my practice is about 10% to 15%. Years ago a surgical procedure call
open capsulotomy was performed. This entailed opening the old incision and removing
the capsule. It was soon learned that this was fruitless, as the capsule almost
always formed again the same way.
It is, however, strongly recommended that closed capsulotomy no longer be done
on those with silicone gel because these older implants are more prone to rupture.
4) Rippling of the implant: Sometimes, when the capsule forms, it can pull
the implant in such a way that it causes it to ripple. This is sometimes felt
and less frequently seen. There is nothing that can be done once this occurs.
Recently I have begun over-inflating the implant slightly. This slight bit of
added tension seems to prevent rippling in most cases. This problem is much
more pronounced with saline implants than with silicone gel-filled implants
because the gel adheres to the inside of the shell and prevents rippling. On
occasion the gel implants can fold slightly so that an edge of the fold can
be felt.
Rippling is much more frequent in women who have stretch marks or very thin
breast tissue after pregnancy (not small breasts, but breast tissue that has
thinned after having a child).
5) Deflation - Leakage: If a saline implant has a manufacturers defect, the
saline would slowly leak out and be absorbed and eliminated. It is totally harmless
- just like drinking salt water. The manufacturers guarantee the implants, providing
a new one for no charge and reimbursing the surgeon a modest amount for replacing
the implant.
Next: Breast Enlargement Complications
from Dr. Bellin's Beauty Science (copyright 2001)
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