Breast Surgery:

History of Breast Implants:

In the early 1960s, manufacturers joined hands with the medical community to develop the silicone gel-filled breast implant which would improve the options for women requiring mastectomies or rectification of congenital deformities. The original devices had a smooth outer cover of silicone rubber (elastomer) filled with silicone gel.

In the next decade, manufacturers attempted to improve the second generation siliconegel- filled breast implants by reducing the thickness of the outer cover and making the silicone gel more fluid to give it a natural feeling. This outer cover was prone to rupture and also there was increased diffusion of silicone gel through the intact breast implant .

Types of Breast Implants:

At present most breast implants are filled with either saline or silicone gel. Currently, there are redominantly three types of breast implants being manufactured:

1. Silicone gel-filled implants.
2. Saline-filled implants.
3. Double lumen implants—silicone gel-filled core and saline-filled periphery.

In all instances the implant contents are enclosed in a dense walled, silicone elastomer envelope. The surface of the envelope may be either textured or smooth.

Over the years, the design, construction and production process of breast implants have been improved by the manufacturers. These improvements are aimed at reducing the risks of capsule formation, gel diffusion and implant rupture. Currently available implants are manufactured under strict quality control guidelines to greatly reduce the possibility of these complications.

Regardless of all the controls, manufacturers cannot guarantee that the use of their implants will not lead to complications. Therefore, all potential breast implant recipients should carefully consider the risks and benefits prior to consenting to surgery.

Silicon and silicone:

Silicon is a chemical element occurring in nature; in fact it is the most abundant element in the earth’s crust. In various combinations it forms sand, rocks and glass.

Silicones are plastics or ‘polymers’. They are complex man-made substances containing silicon, oxygen and other chemical elements. Depending on their structure, silicones can be liquid, gel or solid.

Silicone has been regarded as one of the most compatible materials available for implanting into the human body. Silicones are used in medical devices, medicines and food preparation. All humans carry some silicone in their bodies. Some laboratories claim they can test for the presence of silicone in the blood and urine, but these tests can only show the total amount of elemental silicon. They cannot distinguish between elemental silicon, which occurs naturally in the body, and silicone which may be from breast implants.

Reasons for Breast Implant Surgery:

The main reasons for undergoing breast implant surgery are:

• augmentation to increase breast size and/or shape (cosmetic);
• reconstruction following mastectomy;
• replacement of an existing implant for medical or cosmetic reasons; and
• correction of a congenital deformity.

Anaesthetic:

A general anaesthetic is almost always given for breast implant surgery; in other words, the receipient will be unconscious during the procedure. A local or regional anaesthetic can also be given for breast implant surgery. A patient should be aware that the anaesthetic itself adds a slight but important risk to the whole procedure.

However, with the improvement of medical science these procedures have become very common these days.

After the operation:

It is very likely that you will have a drainage tube in place for a few days to allow any blood or fluid which may collect in the wound to escape.

Time Required for a Breast Implant:

The majority of breast implant surgery is performed as a day surgery procedure, ie, you enter hospital in the morning and go home in the afternoon. However, you may need to stay in hospital for 1-3 days if the surgery is complex or if it is required for medical reasons.

your stay may need to be longer if you have any complications after the surgery.

Post-operative care

It is important that you discuss your care after the operation with your surgeon as the wound may take several weeks to heal.

Breast cancer:

There is no medical evidence to date to show that women with breast implants have a higher chance of getting cancer, including breast cancer. No studies have established a link between silicone gel-filled breast implants and cancer. Long-term clinical studies are not completed, but the risk of breast implants causing cancer would be extremely small. Breast implants may interfere with mammograms which assist in the early detection of breast cancer .

Breast Feeding and Children:

There is no medical evidence to show that breast implants interfere with breast feeding. However, breast surgery may affect the shape, function and sensation of the nipple and surrounding breast tissue. This may make it difficult for you to breast feed. It is suggested that you discuss any possible problems with your doctor or midwife.

There have been no studies to show whether silicone from breast implants is present in breast milk, or whether if swallowed, silicone is absorbed by babies or passes through them. There is no evidence that if silicone is absorbed it will cause illness in the child. It is worth noting that silicone is used as a lubricant
in syringes and no known complications have been reported amongst diabetic children who are being injected daily.

Birth Defects:

There is no evidence that silicone gel-filled breast implants cause birth defects.Studies conducted at various Health Institutes have not found any reason to believe that Breast Implants can cause Birth Defects.

Alternatives to Silicone Gel-Filled Breast Implants

Breast padding and specially designed bras can be used to enhance your appearance without exposing yourself to the risks associated with breast implants. However, if you choose to undergo breast implant surgery, saline filled implants are generally unsuitable in very thin patients with little breast tissue.

Removal/Replacement of Breast Implants.

Your decision to leave your implants in place or to have them removed or replaced is a personal one. Only you, in consultation with your doctor or surgeon, can make it, but you should weigh up all the benefits and risks.

We generally only recommend removal of implants if you are experiencing specific problems such as extreme capsular contracture, constant pain, infection that will not clear up, or rupture. Other factors to consider are how you feel about your implants, your health, your body image and your concerns about the long term health effects of keeping your implants in.

Breast Feeding:

Current information indicates that women with breast implants are able to breast feed. However, there have not been many studies conducted on the effects of silicone on breast fed babies. There is no evidence that silicone from breast implants is present in breast milk, or whether if swallowed, silicone is absorbed by babies or passes through them. There is also no evidence that if silicone is absorbed it will cause illness in the child.

Cost for Breast Implants:

The costs of breast implant surgery are not covered by Medical Insurance unless the operation is for correction of a breast deformity or following a mastectomy.

What you will have to pay will depend on many factors which can only be assessed after a consultation with Dr.Manoj Khanna.

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