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4. Risks with Breast Implants
All
surgery, including cosmetic surgery, carries risks. Although the vast
majority of breast implants patients do not suffer complication and are
very happy with their results, you should not undergo breast augmentation
without the risks having been explained to you. There are two types of
risk; those who apply to any operation, such as bleeding, anaesthetic
risk, and wound infection; and those that apply only to breast implant
surgery. You must discuss these at length with your doctor and Dr Fleming
will give you, at the end of your consultation, an information sheet about
the risks to take away and consider carefully at home. The following explains
some but not all of the risks specifically associated with breast implants.
• Leakage – If saline leaks the salt water is absorbed into the body and there is no health risk. The implants can be replaced. If liquid silicone leaks, there can be problems with inflammation and even scarring in the breast. Therefore we only use the cohesive gel silicone implants which have substantially reduced this risk.
• Implant infection – An infection involving the surface of the implant will probably need removal of the implant and a settling down period of about three months before the implant is replaced. The final result should not be affected.
• Capsular contracture – for reasons that are not known the tissues which form around the implant, and which are normally not visible or palpable can shrink making the implant feel hard. A mild degree of this would probably be accepted by most patients but in the severe cases where the implants can feel like a stone revision surgery will be needed. The overall risk of problematic capsular contracture with textured implants is usually quoted as about 7 %. It was previously thought to be higher with smooth implants but recent evidence shows there is no difference between contracture rates with smooth and textured implants. If capsule contraction does occur it may be treated successfully by a course of tablets for 3 months. If this doesn't work further surgery is needed and then implants will feel soft again. In a small number of women the contraction can happen again. For a women considering breast implants the risk of being a patient who gets recurrent capsule contraction is about 6 in 1000.
• Cancer – There is no increase in the risk of death from breast cancer in women in any kind of breast implant. Breast self-examination and mammograms can be performed effectively in women with implants.
• Sensation changes – Temporary sensation changes in the breast skin and or nipples are common after implant surgery. In the vast majority of patients sensation will return to normal over the period of months. There is a small risk of a permanent loss of sensation which could involve the nipple.
5. Size of Breast Implants
Implants are sized by their weight, measured in grams. 90% of the implants in our clinic are between 250g and 450g. The right size of implant for you depends on the final size you wish to be and the size and shape pf your existing breasts. Sizing can be done by replacing a dummy implant in a crop top or sports bra during the consultation, although using this method alone can be misleading. I prefer to listen carefully to the patient’s requests and then show her before and after photographs of a previous (anonymous) patient whose pre-operative breasts were similar in size and shape to her own. This usually leads to the right choice of size for the new patient. It is worth knowing that many patients, during the consultation, worry about going too big but if a patient regrets her choice of size after the surgery she nearly always wishes she had gone bigger. Therefore if you cannot choose between two sizes it is probably better to go for the better implants.
