On Wednesday 6/22/11, the Food and Drug Administration announced that early findings from an analysis of safety issues and adverse events associated with silicone-gel breast implants revealed no new concerns. Therefore, the agency said it will allow the devices to remain on the market.
The Los Angeles Times (6/23, Mai-duc) stated that the FDA said the analysis conducted on more than 80,000 women over 10 years by implantmanufacturers “indicates that they have a ‘reasonable assurance of safety and effectiveness’ when used properly. … ‘What we can say is the current data doesn’t indicate that silicone gel-filled breast implants are linked to breast cancer, connective tissue disease or infertility,’”
However, women considering breast augmentation with silicone breasts implants should discuss the risks, benefits, and alternatives with their plastic surgeon. It is important for women to understand that 20 percent to 40 percent of patients who have implants for cosmetic reasons will need another operation to modify or remove them within eight to 10 years. I always encourage women to do their research and have all their questions answered before proceeding with any cosmetic surgery procedure.
Dr. Cat Begovic M.D.
Just last week, at least 4 or 5 of my girlfriends who have breast implants asked me this question. I’m not sure how this idea started, but most women think that their breast implants need to be changed routinely. This is not the case – really, implants only need to be removed and replaced if there is a problem. In most cases, the problem involves implant leaks or scar tissue forming around the implant, known as “capsular contracture”. This scar tissue makes the breast feel firm, distorted, or uncomfortable. In the surgery, the scar tissue, or capsule, will also be removed.
Leaks are another reason to replace implants. If a woman has saline implants, it will be obvious if there is a leak. The implant slowly deflates as the saline solution leaks out. If a woman has silicone implants, it is sometimes difficult to detect a leak. This is why the FDA recommends screening for silicone leaks 3 years after implant placement and then every 2 years. Sometimes there are symptoms such as hard lumps, distortion of the breast or implant, swelling, burning, or hardening of the breast. If that happens, the implant should be removed.
Before getting a breast augmentation surgery, ask your doctor about the pros and cons of the procedure. Women who are considering implants should know that they are committing themselves to multiple surgeries over their lifetime. The good news is that if an implant needs to be replaced, the manufactures currently provide new implants for free and often cover part of the surgery fees as well.
Dr. Cat Begovic
I’ve recently had several girlfriends of mine come in for a breast augmentation consultation. Even in this day and age where information about anything can be found on the internet, it is often still confusing for patients. I remember when I got my breast implants, I felt a little overwhelmed by all the information that was out there. Therefore, I use a simple algorithm for my patients to help them through the process.
1) Saline vs. Silicone
Silicone breast implants have recently been FDA approved. Whether a woman undergoes augmentation with saline or silicone implants is a personal choice. The benefits of saline are that if there is a rupture, saline is absorbed by the body. The downside is that they feel less natural than silicone, especially if the patient has little breast tissue. The implants feel quite different – in my office I have my patients feel both a saline and silicone implant to help them make a decision. I also have a silicone implant where I’ve poked a small hole so they can see how the cohesive nature of the gel helps contain the leak
Breast implants are placed through three different incisions. Inframammary fold (in the crease beneath the breast), periareolar (around the nipple), trans axillary (through the armpit). This decision will be made on an individual basis and depends on each patient’s anatomy and the implant size. Overall, all heal well. My implants were placed around the nipple and are barely perceptible. Many of my patients have an inframammary incision and their scar is barely visible.
Most of my patients come in and tell me they want to be a “full C”. However, because bras are sized differently, distorted by padding, and the cup size varies based on the chest width a “full C” is often not what most women think. In general, because I’m a women, I can get a good idea of what my patients are visualizing and it’s easy for me to estimate what size implant they want. We then do the fine-tuning by trying different implants in the office. This is the fun part – to see what you will look like with implants!
4) Implant placement
Implants can be placed under or over the muscle. In general, studies have shown that implants placed under the muscle have decreased incidence of capsular contracture (hard scar tissue forming around the breast causing distortion) but sometimes implants are placed over the muscle create a little breast lift in patients who have mild droop. The decision where to place the implant is made on an individual basis based on the patient’s anatomy.
When you come in for a consultation, I’ll take you through a hands-on, step by step process. There is nothing like feeling the implants in your hands or seeing how they look under your clothes. I personally feel that having breast augmentation was one of the best decisions I ever made. I loved not having to wear padded push up bras under EVERY outfit and even as an active person I actually felt MORE comfortable running and working out in a sports bra not being so flat chested. Living in LA where the average woman spends more time than most in a bikini, tank top or halter dress, I felt so much more versatility in my wardrobe. Honestly, I could talk about breast implants for hours and I truly love being part of this life-changing experience for my patients.
Dr. Catherine Huang-Begovic