Risks of Breast Augmentation Surgery
Risks after breast augmentation are extremely rare. Dr Bonness takes many purposeful steps to minimize and prevent complications. Before surgery Dr. Bonness explains all the risks of breast augmentation during two pre-surgery office visits. Every patient is fully informed of possible side effects of the procedure and you will have plenty of time to ask questions. Dr Bonness wants you to be completely comfortable with your decision.
BI-ALCL is Breast Implant Anaplastic Large Cell Lymphoma.This is an extremely rare cancer that may have an association with textured breast implants. There has been approximately 570 cases reported throughout the world. There has not been a single case reported with smooth implants or with textured tissue expanders. Allergan recently pulled their Biocell textured implants off the market. If you think you have these implants, call your Plastic Surgeon to discuss.
BI-ALCL is NOT a breast cancer. ALCL develops in the scar tissue around the implant. It will present 8-10 years after surgery as a seroma or rarely a mass. A seroma is fluid around the implant making the breast appear larger. If you notice an increase in the size of the breast after surgery, or any change for that matter, you should contact your surgeon.
When detected early the prognosis is very good and treatable with implant and scar tissue removal. If you have textured implants and do not have any symptoms you DO NOT need to remove your implants. With all implants it is important to keep in touch with your surgeon. At Bonness Cosmetic Surgery we like to see patients every 1-2 years. Dr Bonness has always felt it is important to keep in touch with patients for the lifetime of their implants. There is never a charge for a post operative visit.
Breast Implant Illness
The overwhelming amount of data supports that breast implants are very safe. No medical device has undergone as much scrutiny over the years as breast implants. At this time there is not concrete peer reviewed science to support that silicone or saline implants make you sick. However, this lack of robust epidemiologic evidence to support the association should not stop ongoing evaluation. If you are concerned at all about silicone gel making you ill then you should choose saline implants or none at all. This debate has been going on for decades and will not be definitively answered in the next few decades to come.
Although low, capsular contracture is the most common risk. This happens when there is too much scar tissue forming around the implant and it becomes hard, painful and distorted. The scar tissue that forms around the implant is called the capsule. Scar tissue formation is a normal response to a foreign body. The same scar tissue forms around pacemakers and hip replacements. Normally, the scar tissue remains thin and soft, but when the scar tissue around the implant tightens down, thickens and squeezes on the implant it is called capsular contracture.
This tightening can be severe, causing significant firmness to the breast, pain and distortion with implant displacement. Fortunately, the risk of capsular contraction is decreasing because surgical techniques have improved, more implants are being placed using the incision in the fold and most implants are placed under the muscle.
Capsular contracture can happen any time after surgery, but it most commonly occurs within the first 3 years. It can happen in one breast and not the other. In some cases, we know the cause (infection or bleeding), but in most cases, there is no obvious reason.
The best ways to lower the risk of capsular contracture is to have the implant placed under the muscle, through an infra mammary incision by a surgeon who adheres to gentle dissection and current up to date surgical techniques.