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Capsular Contracture

When a foreign object inters our body, our immune system tries to either destroy it or contain it. Some immune systems interpret a breast implant as a foreign object. Since the immune system cant destroy an implant, it tries to contain it. It attempts to build a wall around the intruder to keep it from spreading to the rest of the body. The wall around the implant is called a capsule.

When the capsule tightens around the implant its called capsular contracture. The squeezing can be painful and can change the shape of the breast. The changed shape can affect the appearance of the breast as well.

The severity of the capsular contracture varies between cases. With the mildest case, the breast looks normal and still feels soft. This is classified as grade 1. Grade 2 still looks normal, but the breast is a little firm. At grade 3, the breast is firm and the appearance is considered abnormal. Grade 4 is the most severe and the most painful. The breast looks abnormal and is hard.

You may have to have another operation to fix capsular contracture. The capsule has to be removed, and sometimes the implant has to be replaced. But there are cases where successful treatments have been achieved without any additional surgery.

Its not known exactly what causes the bodys immune system to behave abnormally towards an implant, but capsular contracture can happen after any implant or implant repair surgery. Not just breast implants.

Breast Implant Ruptures

A saline implant rupture results in quick deflation and is easily removed. Recent FDA approved studies show rupture/deflation rates of 3-5% at 3 years and 7-10% at 5 years. Older studies depended on clinical exams to determine rupture rates.

Recent reports have determined these exams arent adequate to evaluate rupture rates. One study reported ruptures in asymptomatic patients are correctly detected by experienced plastic surgeons 30% of the time. This is compared to a detection rate of 86% by MRIs.

The FDA currently recommends MRIs be used to screen for ruptures beginning three years after implantation and continuing every two years thereafter.

Other countries consider MRIs useful only in cases of suspected ruptures and to confirm ultrasound or mammographic studies suggesting a rupture.

Silicone implant ruptures rarely result in deflation. The silicone leaks into the space around the implant. This indicates the need for removal of the implant. The risk and treatment of extracapsular leakage is controversial. Its agreed the gel is difficult to remove, but theres disagreement about the health effects.

The majority of MRI data for silicone gel implants indicates after 11 years, most women had at least one ruptured implant with silicone leakage outside the capsule of 21% of the women. The available long term data deals with 3rd and 4th generation implants and shows a 15-30% risk of silent rupture. MRI evaluation of the 5th generation implants implies improved durability. A rupture rate of 1% or less at an average age of six years is reported.

Breast Augmentation – Not A New Idea

Breast augmentation isnt new. Its not even a twentieth century idea. Women have been trying to improve on nature for centuries. It was only a matter of time before women turned to science and medicine for aid.

In 1889, paraffin injections were tried. The results of this were disastrous. 1895 is the earliest known use of implants. The first one was done by the German surgeon, Vincenz Czerny. He used the adipose tissue (the fatty tissue) from the womans back. This benign growth or a lipoma, seemed appropriate because theyre comprised of fatty tissues, soft to the touch and moveable.

Between 1895 and the early to mid-1900s many other substances were tried. Glass balls, ox cartilage, ivory, Terylene wood, polyethylene chips, ground rubber, polyester, Silastic rubber and Teflon-silicone prostheses were some of the choices.

In 1945 and 1950 attempts were made to rotate the womans chest wall tissue into the breast to add volume. Different synthetics were used during the 1950s and 1960s. An estimated 50,000 women received injections of silicone. In some of these women, hardening of the breasts and development of silicone granulomas (small nodules) were so severe, mastectomies were needed for treatment. 30 years after these treatments, women are still seeking medical services from complications resulting from these injections.

Todays implants are much safer and the instances of complications have been greatly reduced. Hopefully, medical science will be able to keep up with womens attempts to improve on their natural gifts.

After Breast Augmentation Complications

Complications can occur after any surgery. Breast augmentation is no exception. Knowing what to expect before you undergo any surgical procedure can help relieve some stress and nervousness. It also helps prevent the shock and disappointment that may occur if post-surgical complications do arise.

Some complications that commonly arise immediately after breast implant surgery include post-operative bleeding (hematoma), fluid collection (seroma), and infection at the site of the surgical incision. Later complications may include chronic breast pain, alterations in breast and nipple sensitivity, and interference with breast feeding,

Feelings in the breast and nipple can change after the implant surgery has been completed. These changes may include increased sensitivity, chronic pain and lack of feeling in the breast or nipple for several months or even years following the implant surgery. Within the first few years, 2-8% of breast augmentation patients report experiencing chronic breast pain.

Another 1-2% report breast sensitivity changes, and 3-10% experience nipple complications like losing sensations within that area. These reports are generally the same for both silicone gel and saline implants.

But long term data does indicate that 17% of women experience after-surgery breast pain within five years of saline implants. This change in sensitivity is usually either temporary or permanent. It may also have an affect on sexual response and the ability to breast feed a baby.

Being aware of these and other possible complications will help you make an informed decision and may aid in long term satisfaction with your breast augmentation.