Silicone prostheses were first sold in the 1960’s and, currently, are the first option for breast augmentation or reconstruction. A wide variety of prostheses exist in the market today and they differ from each other in the quality and quantity of the covering layer, number of chambers, types of filling or shape. In Spain, silicone gel and saline implants are the ones most widely used.
Breast implant complications:
- Capsular contraction. Like any other materials that are strange to the body, silicone makes the body form a fibrous tissue or fibrous capsule around the device. When this membrane grows exceedingly thick, it causes shape and consistency alterations which result in discomfort; this is called capsular contraction. This contraction can develop into different levels and can form, on one side or both, any time after the operation. This problem can be treated both before and after its appearance.
- Gel leaking. There is a certain trend of gel micro-drops leaking through the implant’s external covering layer. These drops can stay around breast tissue area or go to other parts of the body. Implant bags are now more leak-proof, so this risk has greatly diminished.
- Implant rupture. It’s difficult for it to happen spontaneously, but it can be due to a trauma, surgical instruments, severe capsular contraction, vigorous breast manipulation or closed capsulotomies. Silicone gel prostheses can cause swelling, sensibility alterations, silicone granuloma formation and gel migration. Ruptured implants must be removed as soon as possible. In saline-filled implant ruptures the saline is quickly absorbed by the body. We recommend changing implants within 10 years after surgery to avoid implant rupture due to wear.
- Other possible complications. Hematoma, seroma and infections don’t usually take place. Unstable or compromised tissue covering, are chemical processes due to excessive prosthesis pressure against the skin and an interruption of wound healing may result in extrusion of the implant. Aesthetic dissatisfaction can be due to different reasons, such as severe capsular contraction which displaces implant position and causes asymmetry ptosis or breast hanging due to skin excess, scar deformities or incorrect size, because of filling loss or bad rapport between the patient and the surgeon as to desired breast volume. Subglandular implants can cause difficulties with mammography screening and a radiologist may have some trouble discerning the early detection of initial breast cancer types. When implants are below the muscle, a greater portion of breast tissue is visible.
Sensitivity in breast, areola or nipple may also be altered after implant surgery. Patients can expect either an increase or decrease in feeling that can be temporary.
A pneumothorax can appear in intercostals nerve block techniques, but it is usually mild and is spontaneously reabsorbed.
- Motives of controversy. There isn’t enough evidence to support any relationship between breast implants and connective tissue disorders, such as auto immune diseases, or that those women with prosthesis have greater risk of suffering breast cancer.