Friday, December 17, 2010

Top 5 Things to Know Before Getting a Breast Implant

TOP 5 Things to Know Before Getting a Breast Augmentation

Breast augmentation (breast enlargement) is one of the most common cosmetic procedures performed in the United States. Most patients who undergo a breast augmentation are very satisfied with their results. However, being an informed patient is critical prior to having any surgery. The following facts are important information that all patients should know before having a breast augmentation.
(Courtesy of Wikimedia Commons & Studio Harcourt Paris)

1)Implant lifespan:  Like any other medical device, breast implants can not be guaranteed to last an entire lifetime. Any patient who undergoes breast augmentation should know that at some point in their life, the implants will most likely need to be replaced. This would require further surgery.
 2)Need for further surgery:  A recent clinical study had shown that up to 25% of women who had a breast implant may need further surgery within 5 years of the initial surgery.  Another study showed that about 1 in 8 women who received breast implants for augmentation needed another surgery within 5 years.  One should note that the surgical revision rate among different studies, however, varies which ranges from 8% to 25%. 


The need for revision breast augmentation may be due to several reasons.  The most common reason according to a recent study at UCLA was malposition (62%) followed by capsular contracture (hardening of the implant due to surrounding tissues.)  However, a different study showed that the most common indication for revision breast surgery was patient desire for implant size change followed by capsular contracture.  Other reasons for revision breast augmentation include: drooping of the breast, change in breast shape or volume from aging or pregnancy, implant rupture (0.5% at 3 years), and unwanted implant movement.  Regardless of the difference of results from clinical studies, most women with breast implants will most likely need to have further surgery at some point during their lives.
3)MRI and Implant Rupture:  MRI (Magnetic Resonance Imaging) is the study of choice for women with silicone gel breast implants and a history of cancer.  The US Food & Drug Administration recommended regular MRI screening for silicone implant rupture three (3) years after a silicone gel breast augmentation.  The FDA also recommended to repeat the MRI every 2 years subsequent to the initial MRI of the breast.  The evidence for this, however, is lacking.  It is unclear whether the benefits of obtaining an MRI outweigh the risks and potential costs for the patient.  I recommend a shared medical decision making with your plastic surgeon regarding this issue.
4)Breast feeding: Although the ability to breast feed is not guaranteed whether one would have breast augmentation or not, the ability to breast feed may be affected depending on the surgical technique used for breast augmentation . The periareolar incision (nipple approach) may disturb the milk/lactiferous ducts of the breast which may lead to problems with breast feeding.  You should express your concern to your plastic surgeon prior to any breast surgery if you have plans of breast feeding in the future.
5)Alteration of Nipple and Breast Sensation:  The feeling in your nipple and breast may change following breast implant surgery.  The sensation may increase or decrease after a breast implant is placed.  This can range from intense sensitivity or pain, to no feeling at all.  Note that these changes may be temporary or permanent, and may affect ones ability to nurse a baby as well as your sexual response.

Making an informed decision about your surgery is a critical aspect of being happy and satisfied with the results of your breast augmentation.   No article can substitute the valuable information you will receive during your consultation with your plastic surgeon.  I recommend asking one of your Houston plastic surgeons any questions or concerns regarding your surgery prior to undergoing any procedure.


Emmanuel De La Cruz M.D.
The Woodlands Plastic Surgeon


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Silicone Gel Breast Implant or Saline Breast Implant?