What You Should Know Before Breast Implantation

Breast implants are prosthetic medical devices implanted under the breast tissue or chest muscle to augment the breast shape or size or to replace the tissue of the breast. Breast implantation is a standard procedure, with approximately 35 million people having breast implants worldwide. However, there are risks with breast implant surgery.

Key takeaways:
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    There are two types of breast implants: saline- and silicone-filled.
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    The life expectancy of an implant is ten years. As the implant increases in age, so does the risk of leakage.
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    There are risks with breast implants. These range from minor discomfort to deformation to breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).
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    Breast implant illness is a group of symptoms that appear after implant and go away after implant removal.
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    Any association between breast cancer and breast implants has not yet been proven.

Types of breast implants

There are two types of breast implants, saline-filled and silicone-filled. The Food and Drug Administration (FDA) approves both breast implants for use in the United States. Though they are approved for use, these implants still carry risks. Before deciding on any surgical procedure, the risks should be considered.

Saline-filled breast implants

Saline-filled breast implants are silicone shells filled with saline. Most often, these implants are filled with saline after placing them in the chest but can be filled before placement. Saline-filled breast implants tend to be more uniform in shape.

This type of breast implant, when used for breast augmentation, is approved for people 18 years of age or older. For breast reconstruction, saline-filled breast implants are approved for any age.

A structured saline breast implant is a type of saline-filled breast implant. This type still contains saline but contains an inner structure. This breast implant is believed to feel more natural than the saline-filled breast implant with no internal structure.

Silicone-filled breast implant

Silicone-filled breast implants have a silicone outer shell, like the saline-filled breast implant, but are filled with silicone gel. These implants come filled before being placed in the chest. Silicone breast implants typically feel more natural than the saline-filled option.

Here again, silicone-filled breast implants are approved for anyone needing breast reconstruction. As for breast augmentation, this type of breast implant is approved for people aged 22 or older.

Form-stable – or gummy bear – breast implants are a form of the silicone type. They are called gummy bears because they maintain their shape like gummy bears. The consistency of the silicone gel inside is thicker, resulting in more firm implants.

Type of breast implant shells

Each of the two types of breast implants has a silicone outer shell. These shells themselves can be different, too.

Smooth shells

Smooth shells are the thinnest of the two types of shells. Because they are thin, they feel more natural. They also move more freely, behaving like a natural breast during activity.

Textured shells

A textured shell is thicker and can be coarse to the touch. They are firmer as well. The textured shell has a functional purpose that the smooth shell does not. The texture helps keep the implant in place. This makes them less likely to shift and rotate.

Risks of breast implants

There are short-term and long-term risks associated with breast implants. The short-term risks are those associated with surgery and usually resolve soon after surgery. Such risks are incisions and pain. Long-term risks occur after surgery.

Breast implants are not intended to last forever. They last about ten years. The longer a person has implants, the risk of surgery to remove or replace the implant increases. The reasons for surgery may be:

  • Deflated breast
  • Leaking implant
  • Shifting or rotation of the implant
  • Breast implant illness
  • Scar tissue removal

Rupture or leaking

When a saline-filled breast implant leaks, the saline flows out of the shell and is absorbed into the body. These leaks are noticeable as the breast becomes visibly smaller and deflated.

A silicone breast implant will not become deflated when it leaks. The silicone gel will stay within the implant shell or the pocket of the breast implant. Signs of a silicone leak may be pain, swelling, or a change in shape.

When a breast implant leaks, it is surgically removed. A new breast implant can usually be placed in the same procedure.

Causes for rupture may include:

  • Compression during a mammogram
  • Capsular contracture
  • Damage during procedures such as biopsy
  • Aging of the implant
  • Over or under-filling saline-filled implant
  • Placement through a non-FDA-approved incision site
  • Too much handling during surgery

Capsular contracture

Capsular contracture is a condition where scar tissue changes the shape of the breast. Scar tissue forms around the implant and squeezes it. This results in the shape changes of the breast. This condition can result in surgery when the breast becomes misshapen, firm, and painful.

The actual cause of capsular contracture is unknown. It appears to be more common when an infection, hematoma, or seroma occurs. The correlation between these events and the condition is still being studied.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)

There has been no proven association between saline- or silicone-filled breast implants and breast cancer or connective tissue diseases. There is still much research being done on the topic.

A low but increased possibility of being diagnosed with anaplastic large cell lymphoma exists. In this case, it becomes BIA-ALCL. This is a type of lymphoma that develops in the tissue around the breast implants.

As researchers continue to learn about this condition, it appears that it occurs more frequently in cases of implants with textured shells.

Breast implant illness

Breast implant illness is an accumulation of symptoms experienced after breast implant surgery and resolves when the implant is removed. Such symptoms include:

  • Fatigue
  • Joint pain
  • Memory loss
  • Rash
  • Brain fog

These are not the only risks associated with breast implants. Other risks may include:

  • Wrinkling
  • Decreased milk production during breastfeeding
  • Unable to breastfeed
  • Thinning and shrinking of the skin

Breast implants are common worldwide. There are two types of breast implants approved for use in the United States: saline- and silicone-filled. Each type of these comes with risks. These risks range from short-term risks, such as wound healing, to post-surgical pain, to long-term risks, such as leaking and illness. Long-term risks can result in removing the breast implant with or without replacement. Before deciding on breast implant surgery, it is essential to be informed of both the advantages and risks.

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