Q.-Why can't
I have silicone gel-filled breast implants? A.
The short answer is because
the Federal Drug Administration (FDA) in the early 1990's greatly restricted
the use of silicone gel-filled breast implants and excluded their use
in routine, first-time breast augmentation.
Q.-Why are
saline-filled breast implants usually put underneath the chest wall muscle? A.
Saline-filled implants are more likely than silicone gel-filled implants
to have vertical ridges, usually in the upper half of the breast. Women
with original A or small B cup size breasts will notice these vertical
ridges more than those with larger "original" breasts. By placing
the saline-filled implant behind the muscle in small breasted women, the
vertical ridges are diminished by the extra bulk of the overlying muscle.
Another method to decrease the ridges is to "overfill" the implant
with saline, but that makes the implant feel more firm.
Q.-What
is capsular contracture? A.
All foreign objects
(like breast implants) cause the human body to form a thin layer of scar
tissue between the implant and the body (scar capsule). In some individuals,
the scar tissue (for reasons we don't fully understand) will become thicker
and shrink tightly around the implant. When the scar capsule contracts,
the shape of the implant is changed into a round ball. The breast appearance
also changes and it feels much firmer. Occasionally, the contracture is
so severe that it is painful
Q.-How is
capsular contracture treated? A.
Many years ago capsular contracture
was treated by squeezing the breast very firmly, thus causing the scar
capsule to tear, resulting in a softer, more natural feel and appearance
to the breast. Unfortunately the pressure generated by the squeezing may
rupture the implant. Today most plastic surgeons will treat capsular contracture
by an operation in which the scar tissue is partially or completely removed
or cut in multiple areas and the pocket (space in which the implant is
placed) is enlarged.
Q.-What kinds of implants are currently available? A. The
only type of breast implant currently available in the United States for initial breast
augmentation is the saline-filled implant. It can have either a smooth or roughened
(textured) silicone rubber shell and is available in either a round or tear-drop shape.
Tear-drop shaped implants are available only with a textured shell.
Q.-How long
will my implants last? A. As
reported at the November 2001 meeting of the American Society of Plastic Surgeons, saline-filled
implants have a deflation rate between one and four percent per year (within I 0 years
after augmentation, 10% - 40% of saline- filled implants will have to be replaced because
of deflation). The fate of gel- filled implants is unknown because there is often no
change in breast volume when a gel-filled implant ruptures.
Q.-After
breast augmentation, will I ever need another operation because of the implants? A. A 2001 report from the Plastic
Surgery Educational Foundation Breast Implant Registry found that 15% of over 1,900
implanted patients underwent re- operation. The reasons for re-operation were: 30% capsular
contracture, 25% change in implant size, 19% implant rupture or deflation, 16% patient
request, 8% implant migration and 2% infection. Another survey of 3,000 augmented women
disclosed a re-operation rate of 12-20% within 5 years of the initial augmentation.
Q.-Can
breast implants cause breast cancer? A. One out of every nine women in
the United States will develop breast cancer. A number of studies have concluded that
there is no correlation between breast implants and breast cancer. The incidence of
breast cancer is the same for women with breast implants as it is for women who have
never had breast implants.