Breast implants are like any material foreign to the body, interact with it and transform . Therefore, in general, it is necessary to change them. What is variable is the period in which this must be done ”, Carmen Iglesias, head of the Plastic Surgery section at the Plastic Surgery and Burns Service of the La Paz University Hospital (Madrid) and member of Communication and Social Networks of the Spanish Society of Aesthetic and Reconstructive Plastic Surgery (Secpre) .
“You don’t have to change them every ‘x’ years, but you have to assume that wearing implants may need to be done at some point throughout the life of the woman,” says Jesús Benito Ruiz, president of the Spanish Association of Plastic Aesthetic Surgery (Aecep) .
In this regard, Iglesias indicates that “the time for replacement is variable and depends on the type of implant, the inflammatory capacity of each organism and other factors that we do not know.”
Reasons why change is necessary
In general, the causes for replacement of a prosthesis may be: a capsular contracture appears, the prosthesis ruptures, the patient wants an aesthetic change, anaplastic giant cell lymphoma associated with breast implants (LACG-AIM) or the appearance of autoimmune disorders. The vowel of the Secpre explains each of them in detail:
- Undoubtedly, the first cause of implant change is the change in the patient’s desire, due to the inherent changes over time, weight loss or gain, or pregnancy and lactation.
- Capsular contracture is a frequent entity(it happens in up to 10 percent of prostheses) that depends on the patient, the type of prosthesis and the plane in which it is placed. It appears as a hardening to the palpation of the prosthesis and an ascent of these, sometimes painful. This complication is more frequent with smooth surface implants, although it also occurs in textured ones. Its treatment is usually surgical.
- The breakage of the prosthesis occurs due to deterioration of the material. We do not know the time that must pass for it to occur, nor the exact factors that generate it, although the material’s own fatigue is one of them.
There are patients in whom the prostheses remain intact after 20 or 30 years and others in which they are broken earlier. Any change in the shape or consistency of these can make us suspect a break. Therefore, the monitoring of all breast prostheses is very important. A clinical suspicion should be followed by confirmation by an imaging test, either an ultrasound or an MRI. When the radiologist is an expert, ultrasound may suffice. For doubtful cases, an MRI is required.
In any case, in most prosthetic breaks silicone is highly cohesive (one of its chemical properties that makes it more resistant to breakage and material leakage) and it is normal for it to remain contained in the capsule that is shape around the prosthesis. Although they need to be changed, there is no need to be alarmed and surgery can be scheduled on a non-urgent basis.
- In the case of anaplastic giant cell lymphoma, clinical suspicion also appears due to a change in the volume of one of the breasts, which increases. This entity has a very low prevalence, almost 1 for every 16,018 implanted women. It is diagnosed by the appearance of a late seroma (accumulation of fluid around the prosthesis), generally from the year of implantation. It is usually a local disease that is treated surgically. Both its diagnosis and its treatment are internationally established by scientific societies and health authorities. This entity is more related to textured implants, although it still requires many studies to get to know it well.
- Regarding the relationship with autoimmune diseases and other symptoms(ASIA / BII), there are still no conclusive works. Plastic surgeons must remain alert to signs of suspicion.
Do I have to undergo reviews from time to time?
“Yes, it is very important to perform implant reviews,” replies Iglesias. “We have to take into account that, in general, women undergo regular gynecological follow-up. This involves an image test of the breasts . If this is normal, it does not require further monitoring; in case of alteration in it, you should go to your plastic surgeon to be examined ”.
According to Benito, “the American drug regulatory agency (FDA) recommends the revision of breast implants every year, although possibly every two years is sufficient. It also depends on the age of the implant ”.
Recommendations for patients
Cosmetic surgery experts give these recommendations for prosthetic patients who need to change their implants:
- Get well informed by a qualified plastic surgeon. If possible, go to the surgeon who operated on you for the first time, who is the one who knows exactly the technique that was used. If not, provide the surgeon with the maximum amount of information, including the type of implant (usually cards are given with information on the implant that must be kept for life).
- Feel free to ask all your questions. You can also contact the Secpre at [email protected] .
- Always ask for the barcodes of your new dentures and save them.
Can you breastfeed with breast implants?
A question that often arises is whether breastfeeding is possible by wearing breast implants. “Breast prostheses can be implanted according to different techniques and approaches that the plastic surgeon and the patient agree on in the consultation and that they obey different principles. Prostheses implanted through the breast or when surgery on it has been necessary for a better cosmetic result may make breastfeeding impossible or difficult, “says Iglesias.
However, the expert continues, those prostheses placed from the submammary groove (the fold between the breast and the chest wall) or from the armpit, and in which no procedure is done on the mammary gland do not alter the course of lactation maternal.
In addition, carrying breast implants is not related to a better or worse grip of the newborn on the breast.
Is there an increased risk of mastitis?
“No. Mastitis is caused by inflammation and / or infection of the breast from the microorganisms that make up our skin. It is generally an infection from the outside to the inside and is not related to the prosthesis. However , mastitis can be more serious and cause complications in the prosthesis, ”explains the Secpre member
