The discrete breast asymmetry is very common in women after they have developed breasts during puberty. However, there are occasions where the asymmetry is so important causing serious disturbances to the patient as it is very evident even when they are dressed.
To correct these asymmetries many techniques are used to equalize the volumes of the breasts and the size of the areolas. Therefore mammary asymmetries can be treated with breast reduction in both breasts, implant prostheses of different sizes, reductions of the periareolar etc.
When using breast implants it is intended that the volumes are not very different among them, since the behavior of the breasts with the passage of time will be different on either side, so if the difference in volume is very large, it is preferred to reduce the breast and implant a greater prosthesis. It is not advisable to implant in one breast only.
Complications that can be encountered in this type of intervention are the same as in breast implants in breast reduction.
Techniques, anesthetics and monitoring methods have made immense progress over the past 20 years, offering an optimal safety, especially when the operation is performed without urgency and a person is completely healthy.
In relation to the act of surgery: choosing a qualified plastic surgeon and who is competent, trained for this type of intervention the maximum risks are limited,without suppressing completely.
The post-operative is generally simple, however the complications may occur some inherent and other interventions linked to the breast implantation of a foreign body in the breast: the specific risks of the breast implants.
1 / Complications inherent to breast interventions:
Infections treated with antibiotics and sometimes with surgical drainage. Hematoma, which may need to be evacuated. Alterations in the sensitivity, essentially to the nipple that can be noticed, but normally the sensation returns in a period of 6 to 8 months. The evolution does not always have scars that may be favorable existing hypertrophic scars and even keloids, unpredictable onset and progression can compromise the aesthetic appearance of the result and requires specific long local treatment.
2 / Specific risks of breast implants:
They are of three types which vary according to the nature of the filling of the implant. This is the formation of folds or waves, production of a capsular contraction periprotérica and the risk of rupture or Deflation:
- Formation of fold or an appearance of waves. The implant to be smooth is never fulled with tension. for this the folds of the coating of the prosthesis may be visible under the skin, thereby producing a wave aspect especially in the upper outer and inferior of the breast. This in more noticeable in the upper part in the event that the prosthesis is placed in position retromuscular. This phenomenon is more common when the prosthesis is filled with saline solution, even if it is textured. This puts even greater risk breaking and deflated by spending premature coating level of the fold.
- Contraction capsular fibrous capsule. Forming a fibrous capsule around the implant always occurs. Is a normal reaction of the organism that produces a sort of membrane around any foreign object to isolate and protect (“membrane or capsule of exclusion”). in certain cases, this membrane has a poor outcome comparable to skin keloids: increases in thickness, shrinks and forms a true fibrous capsule around the implant. This is capsular contraction. There are four stages of hardness ranging from the appearance normally undetectable to severe forms of breast capsule with hardness, round, and sometimes fixed painful. The frequency of this complication can not be estimated as it varies globally depending on the indication, type of prosthesis and surgical technique. This complication is most frequent in the case of prostheses filled with silicone gel. The capsule does not increase the risk of rupture but exposed to a complication of an aesthetic nature. Surgery can correct this complication sectioning the capsule (capsulotomy). Several authors have proposed solutions techniques to limit the occurrence of this contract:
– Place the implant behind the muscle pectoral
– Manufacture of rough walls on the outside of the implant (prosthesis textured)
– The use of physiological saline filled implants.
- Rupture and deflation. This type of accidents occur due to an alteration in the lining of the prosthesis is the continent (silicone elastomer). The phenomenon of porosity, or the opening or punctiform a real gap may be the cause and appear as a result of trauma violent, a manufacturing defect, but mostly due to the age of the prosthesis (effect of use). Deflation in saline containing prostheses may be a problem lost by the filling valve. This type prosthesis has a total or partial deflated quickly. If a prosthesis is filled with silicone gel, the gel remains in the fibrous coating surrounding the implant (intracapsular leak). The flight then has no clinical significance. However, intracapsular exudate can favor the appearance of a capsule periprotética. Less often, if significant gap in relation to trauma violent or a needle, the gel escapes beyond the fibrous capsule (break extracapsular). In small amounts, the gel can cause the appearance of a granuloma or body strange in the form of nodules (siliconoma). In case of rupture important capsular (trauma), the gel diffuses into the surrounding tissue, breast, making a very soft consistency, and inflammatory reactions may occur: in these cases the surgical implant is necessary.
Is breastfeeding possible?
Placing the implant behind the gland seems to have no influence on breastfeeding.
Does having breast implants induce the risk of breast cancer?
The relationship between breast cancer and prosthesis was investigated to reveal that there is’nt any link between the two and the mammary prosthesis implantation does not increase risk at all to breast cancer. Surgeons frequently used anticancer centers prostheses breast reconstructive surgery.
Is the monitoring of the breast possible?
Considering that the prosthesis is behind the breast, clinical monitoring is simple. The presence of an implant can alter the ability of X-rays to detect breast cancer. The patients who have breast implants should inform the radiologist in order to use specific adapted methods (ultrasound, digital mammography).
Why were there so many controversial silicone implants a few years ago?
Breast prostheses filled with gel silicone were accused of triggering autoimmune diseases in some patients. today in these days, all scientists working in this area have produced evidence that there is no significantly increased risk of autoimmune disease in women carrying breast implants and particularly those filled with silicone gel.
Is there a surveillance after implantation of a breast prosthesis?
It is necessary to have postoperative visits as adviced by the surgeon’s prescription. Subsequently, the presence of a breast prosthesis does not imply additional tests to routine medical surveillances but it is essential to specify to the doctor that you are carrying breast implants. It is imperative in case of changes in one breast (hardening or softening or the contrary) doctor (gynecologist, surgeon) who will judge whether it is necessary to use an X-ray or ultrasound in summary, one should not exaggerate the risks, but just be aware that an intervention surgery, even seemingly simple, always implies a small random part. Resorting to a experienced qualified plastic surgeon says that this is the qualifications required for avoid these complications, or otherwise treat them effectively.