Risks associated with the use of breast implants Introduction Anything you do has risks involved. When you cross the street, a car can run over you. When you eat, you might choke on a piece of bread. This doesn’t mean you will never cross a street or eat a piece of bread. You will only be more careful when you cross the street or eat your meal. The same goes for any surgery. Whenever you have to go under the knife, a wide range of risks are implied. Before any operation, even the simplest one, the medical team will ask you to sign a lot of papers that cover the most common risks of surgery such as side effects of anesthesia, sudden death, etc. These almost never happen, but you need to be informed of everything. Even breast augmentation surgery implies risks not only from the surgery itself, but also from the use of implants. Implant rupture One of the most common risks is implant rupture. There is no implant that will last forever. There are some that will last for more than 15 years, and some that will tear after just a year or so. The quality of the implant is undoubtedly of great importance, so it is advisable to look for a surgeon that works with certified implants. If your implant is saline, then you will probably notice right away that there is a problem with your implant. Water is very fluid, and your breast will deflate immediately or over a few days, so the difference in size and appearance will be evident. Also, the liquid contained in the shell is simple saline water, so your body will absorb it with no harm done. Now, when it comes to silicone implants, things are a lot more complicated. Women tend to choose them more often, because silicone implants are known to have a longer lifetime compared to saline ones and they also look and feel closer to a natural breast. The main issue when it comes to their rupture is that in very few cases you or your doctor will able to notice without a proper scan. There will be no silicone spread into your body. Because silicone is very dense, you will not look any different because it will leak bit by bit. You might get some symptoms together with the rupture of silicone implants like pain or tenderness, lumps in the breasts, etc. You will probably have to get an MRI scan if your doctor suspects you might have a leakage. The FDA even recommends an MRI once every two years for women with silicone implants. Capsular contracture Another risk is that of developing a thick scar tissue around the implant. Implants are perceived by our body as foreign objects invading personal space. Therefore, they will be attacked by our immune system. To protect itself, it will create a capsule of scar tissue around the implant to isolate it. In some women, this scar tissues becomes extremely thick and will squeeze and deform the implant. The affected breast will look strange, deformed, or unnatural due to this abnormal scar tissue growth. When this happens and the degree of contracture is very high, the only possible solution is another operation. During this new surgery, the doctor will remove the thick capsule and then he will put the implant back in. This doesn’t mean that you will not ever develop another capsular contracture around the same implant. It seems that some people are prone to developing this type of reaction to almost any kind of surgery, so it seems impossible to prevent it. Mammography obstruction and/or risk Another issue we need to address here is mammography. Yes, there is a small risk that a mammogram will split your implant or cause more leakage to an already ruptured one. Still, all doctors recommend women that are after age 40, no matter if they have implants or not, to have a mammography at least once every two years in order to be able to catch an early sign of breast cancer. You need to tell the radiologist that you have breast implants. He or she will allow more time for your mammography and will handle your breast carefully to prevent rupture. Doctors say that implants might make early breast cancer detection more difficult. That is because silicone is a very dense substance and it obscures glandular tissue. But there is no definite consensus on this matter. Losing the ability to breastfeed There is also a small risk of not being able to breastfeed after breast implant surgery. This risk takes into consideration several factors like the location of the incision, the position of the implant, the size of the implant, and the formation of scar tissue. If the incision is made in the fold under the breast, then there is no danger of the milk ducts to be affected. If the incision is made peri-areolar or around the areola, then this kind of incision will imply this risk. This kind of incision might affect the nerves of the nipple and you can lose sensation in the nipple. This might lead to the inability to breastfeed. Also, this type of incision carries the risk of affecting the milk ducts and will impact milk supply and production. Since the areola incision is usually chosen due to aesthetic and not medical reasons, you will be able to choose an incision that will not be affecting your future ability to breastfeed if this is your plan. The position of the implant might also be an important factor adding to this risk. The breast is made up of glandular tissue that produces milk and muscle. When the implant is placed above the muscle, between it and the glandular tissue, some say that this can exert increased pressure on the tissue and therefore obstruct milk production. If the implant is placed under the muscle, then no pressure will exist, so this will not have an impact of any kind on your ability to produce milk. According to research by the American Federal Institute of Medicine, 12% to 25% of women undergoing breast implant surgery have lost feeling in their nipples post-operation. Again, this can happen only when the incision is made around the areola. The nerves around the nipple are very important for the correct functioning of it. If they are in any way cut or partially severed, there is the possibility of losing feeling in your nipples. There is another possibility of extreme sensitivity that will lead, in case of a pregnancy, to excessive engorgement and pain during lactation. Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) Recently a new kind of risk has emerged during some studies of a very rare kind of cancer. Research on this subject is not yet finalized since there exist few cases of this specific type of cancer. Nevertheless, all studies have linked this type of lymphoma to the existence of breast implants. This is called Breast Implant-Associated Anaplastic Large Cell Lymphoma, which is a treatable form of cancer of the cells of the immune system. It is not a type of breast cancer, but one of the blood cells. Statistics have not shown that women should take off or avoid implants because of this. Only 3 in 100 million women have been diagnosed with this disease. Since it is so rare and it is relatively new as a disease, there is little information collected on it, so possible triggers are very hard to discover. Until now, studies have shown that women with textured implants might be more prone to this type of cancer. Also, it was found mostly in women with the presence of a seroma, a liquid that forms between the implant and the scar tissue. But this might be just a coincidence since the symptoms associated with the seroma have led the patient to seek medical attention and therefore the chance discovery of the rare type of cancer. You need to know that the chances are so small that some doctors even said that the chances to get this type of cancer are like those of dying from a snake bite. Nevertheless, you should pay attention to your body and any changes you see in your breasts and the way they feel. Conclusion Risks are just a necessary part of our life. But informing ourselves and learning of all things that might go wrong, we will know what to expect no matter what happens. It is shocking and might be really frightening to see your breast move upward and/or distort. But if you know that this might happen, you will be able to sleep well until you see your doctor and see how you can correct it. Knowing the risks will prevent you from being unpleasantly surprised.