What every woman should know about Silicone Breast Implants

Silicone Implant

The FDA has recently required all surgeons performing breast augmentations or reconstructions with silicone gel implants to have patients read and complete a questionnaire to ensure the proper education of these patients regarding the risks associated with silicone gel breast implants. Although most surgeons do their best to educate their patients regarding these risks, in a sometimes busy practice, it may be hard to address all the issues involved. The questionnaire that is now required, will give the patient a chance to review risks on their own time and will allow them a chance to reflect more thoroughly on this important decision. Key takeaways from the questionnaire are as follows:

  1. Patients with certain medical conditions are not candidates at all

Patients with an active infection anywhere in their body are not candidates for this procedure. Patients with untreated breast cancer are also not candidates. Finally patients who are pregnant or breast feeding are not candidates for the procedure.

2. Patients with certain medical conditions are at high risk of complications

Certain conditions may impair the body’s ability to heal. These conditions include diabetes and connective tissue disorders.

Certain exposures to drugs or toxins or radiation may also impair healing. Active smokers are a risk, as well as patients taking certain drugs that affect the body’s immune response to healing, including chemotherapy and steroids. Patients with a history of radiation therapy to the chest wall may also have a higher risk of complications

In these cases the surgery can still take place and be successful, but your surgeon will suggest ways to ameliorate these higher risks by adjusting the surgical plan.

3. Even in the healthiest patients there are risks to consider

Regardless of medical history, breast augmentation or reconstruction surgery can result in breast pain, nipple/areola sensitivity changes, asymmetry, infection, scarring, seroma (fluid in the implant cavity), hematoma or bleeding, inability to breast feed, and anesthesia complications. Some of these complications may occur in as high as 30% of patients.

Your surgeon, after a full evaluation of your medical history and physical exam, will recommend the best surgical plan to ameliorate these risks and obtain you the best outcome. It is important to note that you can still obtain an excellent result, but that no surgical endeavor is risk free.

4. Silicone gel implants carry the risk of Breast Implant Associated Lymphoma

Textured silicone gel breast implants are associated with the development of a type of cancer of the immune system called Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIAALCL). No cases have been reported in women exposed to smooth implants only. The incidence in patients with textured implants is reported at 1 in 30,000 patients (Doren EL, Miranda RN, Selber JC, et al.U.S. epidemiology of breast implant-associated anaplastic large cell lymphoma. Plast Reconstr Surg. 2017;139:1042–1050.)

Smooth and Textured Breast Implants

BIA-ALCL typically takes several years to develop after implantation, but cases have been reported as early as within one year. Typical symptoms to be aware of include: swelling, breast tightness, pain, lumps, or swelling of the breast months or years after receiving the implants.

Any swelling, mass, pain or discrete lumps in the setting of a silicone breast implant needs to be investigated

The treatment is en-bloc capsulectomy and implant removal done in a timely fashion. Some patients have required chemotherapy or radiation.

The use of smooth silicone gel implants is recommended to avoid the risk of this illness.

5. Breast Implant Illness is a rare but real condition
Some patients who have received breast implants have reported a variety of systemic symptoms including joint pain, fatigue, rash, memory loss, and “brain fog” that some patients have called breast implant illness. Some patients have reported relief of these symptoms with removal of their implants and surrounding scar tissue capsule, however not all patients may experience improvement in their symptoms.

Researchers are working to better understand the possible link between breast implants and these

6. Breast Implants are not Considered Lifetime Devices

Silicone breast implants are NOT lifetime devices and the longer implants are in place, the more likely a patient is to require a reoperation due to implant rupture, requiring the replacement or removal of the breast implant. As many as 20 percent of women who receive breast implants for augmentation have to have their implants removed within 8 to 10 years, but implants may last for a shorter or longer time.

Ruptured Gel Implant with Textured Shell

Periodic imaging evaluation is recommended for screening of silicone gel-filled breast implant
rupture. If an implant ruptures, the silicone over time may migrate from my implant into nearby tissues (e.g., chest wall, lymph nodes under the arm) and organs (e.g., liver, lungs) where it may not be possible to remove.

Visit us a Thomassen Plastic Surgery to further discuss the risks and benefits of breast implant surgery.

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