Breast Augmentation Surgery – Problems and Risks

There have always been women who have suffered the agony of small, underdeveloped, or sagging breasts. Many have just accepted this as a frustrating but unchangeable situation. Some women, especially from the upper socio-economic classes, have opted for insertion of breast implants by breast augmentation surgery. However, because of the high cost, the risks and the side-effects of breast implants, today better-informed women are becoming hesitant about opting for surgery and are increasingly turning to natural breast enlargement.

The cost and risks of cosmetic surgery make this an undesirable option. The average cost of a breast enhancement surgery is between $5,000 and $6,000. Most people either don't have this kind of money to spend on breast enlargement or prefer to keep this cash for more productive and meaningful purposes!

Nevertheless, breast augmentation is the No. 1 cosmetic surgical procedure performed in the U.S., up 756 percent since 1992, according to the American Society of Plastic Surgeons. In 1992, there were 32,600 procedures; in 2005, it skyrocketed to 279,000.

Yet, despite the popularity, the procedure has been and remains controversial because of the cost, the risks, and the problems of ruptures or leaks in the implants. Meanwhile, millions of women have been subjected to the ill effects of these modern day vanity procedures that were bought in good faith.

Types of Implants

There are two types of implants used in breast enhancement surgery - silicone gel or saline solution. Of these, silicone gel implants are considered to have a superior appearance, superior feel and look more natural compared to saline implants.

However, silicone gel implants are far more dangerous than saline implants. In case of a rupture, the silicone gel can spread into the body, with serious consequences. In fact, the FDA had banned silicone implants in 1992. However, with improved silicone implants becoming available, this ban has recently been lifted.

Saline-filled implants are safer than silicone ones. This is because, should the implant rupture, the saline solution will simply be absorbed by the body. However, saline implants tend to have a higher rate of leaking and deflation than silicone gel implants, which means more frequent surgery to replace them.

Breast Implant Risks and Side Effects

From special mammography considerations, to breastfeeding, to implant leakage, plus the inherent risks in any form of surgery, there are several issues connected with breast implant surgery that one should be aware of, in order to take an informed decision on this matter.

Breast Feeding

Many breast implant patients do successfully breastfeed. However, breast implants may, and often do, interfere with breast feeding. If you plan to breastfeed at any time subsequent to your surgery, you must tell your plastic surgeon about this.This factor may impact the surgical technique used.

Mammography

There is a risk that breast implants may impede breast cancer detection. During mammography, X-ray, or ultrasound, the implants can hide suspicious tumors or lesions. Treatment providers must take special care of breast-implant patients during breast exams. Additional views are required, which take additional time for imaging. If you have had breast implant surgery, you must mention this when you make a mammography appointment, so that they can schedule the extra time and special imaging needed.

The radiologist needs to use special imaging - "Eklund displacement views” should be included, in addition to the standard views, to detect lesions and tumors for women who have breast implants.

Mammography also compresses the breasts, which increases the chance of  implant rupture, which will require further surgical intervention.

Loss of Sensation

After breast enhancement surgery, some women experience loss of sensation in the nipple and breast areas. Loss of sensation results from damage to nerve endings in the breast and nipple. This loss of sensation may be temporary, but it can also be permanent. The surgical technique used plays a role in this factor.

Leaking or Leaching of Breast Implant Material

There have been several studies of the potential harmful effects of breast implant materials leaking or leaching into the surrounding breast tissue. The studies concluded that there is insufficient evidence of harmful effects caused by implant materials that are approved by the FDA. These FDA-approved materials are also widely used in other types of medical implants, including pacemakers, intraocular lenses, artificial joints, and other medical devices.

Rupture

The FDA has published a brochure to highlight the more common problems that occur with silicone gel-filled or saline-filled breast implants.

In this brochure, the FDA states:

"Capsular contracture and rupture/deflation are the most common local complications that occur with both silicone gel-filled and saline-filled breast implants.

Capsular Contracture

Capsular contracture occurs when the scar tissue or capsule that normally forms around the implant tightens and squeezes the implant. It can happen to one or both of the implants. There are four grades of capsular contracture known as Baker grades.

The Baker grading is as follows

Capsular contracture may require re-operation. Re-operation is almost always needed for Grades III and IV, and it may occur again.

Breast implants do not last a lifetime. Some breast implants may rupture/deflate in the first few months after surgery and some after several years. Others may take 10 or more years to rupture/deflate.

When silicone gel-filled implants rupture, some women may notice decreased breast size, hard knots, uneven appearance of the breasts, pain or tenderness, tingling, swelling, numbness, burning, or changes in sensation. Other women may unknowingly experience a rupture without any symptoms (silent rupture). Silicone gel may escape from the scar tissue capsule around the implant, migrate away from the breast, cause lumps, called granulomas, to form in the breast, chest wall, armpit, arm, or abdomen.

Plastic surgeons usually recommend removal and replacement of the implant if it has ruptured, even if the silicone is still enclosed within the scar tissue capsule, because the silicone gel may eventually leak into surrounding tissues.

Acknowledgements:

Safety of Silicone Breast Implants. Institute of Medicine National Academy Press, Washington, D.C. 2000. (IOM Report). Also available through IOM website at www.iom.edu/report.asp?id=5638 

Long Term Risks of Breast Enhancement Surgery

Other than the side effects and risks outlined above, an issue of much greater concern is the serious possibility of increased incidence of cancer and other life-threatening conditions.

Two major new studies raise questions about the long-term safety of breast implants. A team of researchers led by Louise Brinton, Ph.D., of the National Cancer Institute (NCI) recently published these studies on the long-term health effects of breast implants. One of the studies found that women with breast implants are more likely to die from brain tumors, lung cancer, other respiratory diseases, and suicide compared to other plastic surgery patients. The other study found a 21% overall increased risk of cancer for women with implants, compared to women of the same age in the general population.

While the authors were not able to determine whether implants were the direct cause of  these illnesses, the results show a doubling of brain cancer and a tripling of lung cancer, emphysema, and pneumonia for women with implants. Even though these findings were described as "unexpected," they are consistent with previous research that shows brain abnormalities and lung problems related to breast implants. There was also a four-fold increase in suicide for breast implant patients, which is a very troubling situation.

Alternatives to Breast Enhancement Surgery

Given the many problems associated with breast augmentation surgery, the well-informed woman of today is increasingly looking for alternative solutions for breast enhancement. Women troubled with small or unshapely breasts need a solution to their problem, without the exorbitant costs and many risks associated with surgical breast enlargement.

Natural breast enlargement and enhancement are now proven to be effective and safe options, based on stimulating the estrogen receptors in the breasts with complex phytoestrogens from plant sources. Increasingly, women needing breast enhancement are opting for these natural solutions in preference to surgery.