Breast Implant Safety NYC

As breast implants have gained popularity over the years, concerns about the potential risks and complications associated with the procedure have also grown. While breast augmentation and reconstruction can improve self-confidence and quality of life, it is essential to understand and be cautious of the risks that come with breast implants. This article will address four key concerns related to breast implants: breast implant rupture, capsular contracture, breast implant illness, and BIA-ALCL. Lastly, we will discuss the importance of early detection in minimizing these complications.

Breast implants after removal

Worrying About Breast Implant Rupture or Leakage

A breast implant rupture or leakage is a significant concern for many women. It occurs when the silicone or saline solution inside the breast implant leaks into the surrounding tissue. Various factors, such as trauma to the breast or defects in the implant, can contribute to this issue. The FDA warns that the risk of breast implant rupture increases over time, with one study finding that up to 20% of women with silicone implants experienced rupture within ten years of having the implant placed.

If you're worried about a potential breast implant rupture, be vigilant about seeking medical attention as soon as possible. Look for common signs like changes in breast shape or size, pain or discomfort, and swelling or redness in the breast area. Early detection is crucial in preventing further complications, such as infection or capsular contracture.

Capsular Contracture:
A Cause for Concern

Capsular contracture can be a troubling complication for women with breast implants. It occurs when scar tissue forms around the breast implant, causing the implant to become hard, misshapen, or painful. Infection, trauma to the breast, or a reaction to the implant material can lead to this problem. A study published in the Aesthetic Surgery Journal indicates that the risk of capsular contracture can range from 0.3% to 15%, depending on the type of implant used and other factors.

Example of capsular contracture

How to Recognize Capsular Contracture

Being aware of the signs and symptoms of capsular contracture can help you identify this complication early and seek appropriate treatment. Capsular contracture can manifest in various ways, and the severity can range from mild to severe. If you suspect you may have capsular contracture, look out for the following signs:

  1. Hardening of the breast: One of the most common indications of capsular contracture is a noticeable hardening or firmness of the breast, which can be felt when gently pressing on the breast tissue.

  2. Changes in breast shape: Capsular contracture may lead to a visible change in the shape of your breast, such as distortion, unevenness, or an unnatural, round appearance.

  3. Pain or discomfort: As the capsule tightens around the implant, it can cause pain, discomfort, or a feeling of tightness in the breast area. This discomfort may increase over time and can become more severe in advanced cases.

  4. Implant displacement: In some instances, capsular contracture can cause the breast implant to shift position, leading to asymmetry or an unusual implant location.

If you notice any of these symptoms or have concerns about the possibility of capsular contracture, it is essential to consult with your plastic surgeon or healthcare provider promptly. They can assess your condition and recommend the appropriate course of action to address capsular contracture and restore the health and appearance of your breasts.

Treatment Options for Capsular Contracture

If you are diagnosed with capsular contracture, your plastic surgeon will discuss the most suitable treatment options based on the severity of your condition and individual circumstances. Some of the common treatment approaches for capsular contracture include:

  1. Non-surgical interventions: In mild cases of capsular contracture, conservative measures such as oral medications, including anti-inflammatory drugs or antibiotics, may be prescribed to help alleviate symptoms and manage the condition.

  2. Capsulectomy: For more severe cases of capsular contracture or when non-surgical treatments are ineffective, a surgical procedure called capsulectomy may be recommended. This procedure involves the removal of the entire scar tissue capsule surrounding the breast implant. Depending on the specific situation, the implant may be replaced with a new one or removed altogether.

  3. Capsulotomy: In some cases, a capsulotomy may be performed to alleviate capsular contracture. This procedure involves surgically releasing or cutting the scar tissue capsule to relieve the pressure and tightness around the breast implant. Like capsulectomy, capsulotomy may be performed in combination with implant replacement or removal, depending on the patient's needs and preferences.

  4. Implant replacement or modification: When treating capsular contracture, your surgeon may recommend replacing the implant with a new one, possibly with a different type, size, or texture. This approach may help to reduce the risk of recurrence and improve the overall outcome.

Using Acellular Dermal Matrices to Prevent Capsular Contracture Recurrence

Acellular dermal matrices (ADMs) are specialized materials that can be used in breast implant surgeries to help lower the chances of capsular contracture coming back. ADMs work in several ways to help reduce the risk of capsular contracture recurrence:

  1. Compatibility: ADMs are designed to work well with the body, reducing irritation and reactions that could lead to capsular contracture.

  2. Extra support: ADMs can provide additional support to the area where the breast implant is placed, helping to maintain the implant's position and shape. This support can decrease stress on the surrounding tissue, which may contribute to capsular contracture.

  3. Separation: ADMs can act as a barrier between the breast implant and the body's tissue, which may help minimize the body's reaction to the implant and reduce the risk of capsular contracture coming back.

  4. Improved healing: ADMs can help promote better healing by encouraging the body to form organized tissue instead of excessive scar tissue, which can lead to capsular contracture.

Example of capsular contracture

While using ADMs in breast implant surgery has shown promising results in lowering the risk of capsular contracture recurrence, it's essential to talk to your plastic surgeon about this option. They can help you decide if ADMs are right for you and explain the potential benefits and risks involved. The primary goal of capsular contracture treatment is to alleviate pain, restore the breast's natural appearance, and ensure your comfort and satisfaction with the results.

Breast Implant Illness: An Ongoing Debate

Breast implant illness (BII) is a term used to describe a range of symptoms that some women with breast implants have reported experiencing. These symptoms can include fatigue, joint pain, brain fog, and other issues. Although the exact cause of BII is not yet known, some experts believe that it may be related to a reaction to the implant material or an autoimmune response. Despite the ongoing debate, the FDA currently states that there is no evidence to support a causal link between breast implants and BII.

Treatment Options for Breast Implant Illness

If you are experiencing symptoms that you believe may be related to breast implant illness (BII), it is essential to discuss your concerns with your healthcare provider or plastic surgeon. They can help guide you through the available treatment options, which may include:

  1. Symptom management:
    Your healthcare provider may recommend treatments to help alleviate specific symptoms you are experiencing. This could include medications for pain relief or inflammation, supplements to support immune function, or therapies to address cognitive symptoms such as brain fog.

  2. Lifestyle modifications:
    In some cases, making changes to your lifestyle, such as adopting a healthier diet, engaging in regular exercise, and managing stress levels, may help improve your overall well-being and potentially alleviate some BII symptoms.

  3. Explant surgery:
    For some women, removing the breast implants (explant surgery) may provide relief from BII symptoms. Explant surgery involves the removal of the breast implants and, in some cases, the surrounding scar tissue. It is important to discuss this option with your plastic surgeon, as they can help determine if explant surgery is appropriate for your specific situation and guide you through the process.

  4. En bloc capsulectomy:
    In certain cases, particularly if there are concerns about potential implant rupture or silicone leakage, your surgeon may recommend an en bloc capsulectomy. This procedure involves the removal of the breast implant along with the entire scar tissue capsule surrounding it. This approach aims to minimize the risk of residual silicone or other implant materials remaining in the body.

Having an open dialogue with your healthcare provider or plastic surgeon about your concerns and symptoms related to BII is crucial. They can help you navigate the available treatment options and ensure you receive appropriate care tailored to your specific situation, ultimately enhancing your overall well-being.

BIA-ALCL: A Rare but Serious Risk

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of cancer linked to certain types of breast implants. The FDA reported that as of September 2021, there have been 1,005 unique cases of BIA-ALCL and 36 patient deaths worldwide. The majority of cases have been linked to textured surface implants.

If you have breast implants, it is crucial to monitor for any changes in the breast, such as swelling, pain, or lumps. If you notice any of these symptoms, seek medical attention right away. In some cases, treatment may involve removing the implant and the surrounding scar tissue.

The Importance of Early Screening for Breast Implant Rupture

Early screening for breast implant rupture is vital in preventing further complications, such as infection or capsular contracture. The American Society of Plastic Surgeons recommends that women with breast implants undergo regular MRI screenings to detect any potential ruptures. The frequency of these screenings may vary depending on the type of implant and the recommendations of your healthcare provider.

Although MRI is considered the most sensitive imaging modality for detecting breast implant ruptures, with a reported sensitivity of up to 90%, it can be expensive and may not be covered by insurance in many cases. Furthermore, an MRI scan can take up to an hour to perform, and patients may experience claustrophobia or discomfort during the procedure.

Ultrasound is another option for detecting breast implant rupture. Several studies have investigated the use of ultrasound for this purpose and have reported high accuracy rates. For example, a study published in the journal Plastic and Reconstructive Surgery found that ultrasound had a sensitivity of 89% and a specificity of 97% for detecting breast implant rupture (Handel et al., 1995). Another study published in the Journal of Ultrasound Medicine found that ultrasound had a sensitivity of 85% and a specificity of 96% for detecting silicone breast implant rupture (Kazerooni et al., 2013). One advantage of ultrasound over MRI is that it is less expensive and more widely available.

In summary, ultrasound can be a useful tool for detecting breast implant rupture, with high accuracy rates and advantages in terms of cost, availability, and convenience. However, MRI remains the most accurate imaging modality for detecting breast implant rupture and can detect silent ruptures that may go undetected by ultrasound. Ultimately, the choice of imaging modality will depend on the specific circumstances and individual patient factors.

It is crucial to remember that breast implant ruptures may not always cause symptoms, especially in the case of a slow leak. This is why regular screening is so important for detecting any potential issues before they become more serious.

When to Be Concerned About a Breast Implant Rupture

Being aware of the potential signs of a breast implant rupture can help you detect and address any issues early. Some common symptoms of a breast implant rupture include:

  1. Changes in breast shape or size
  2. Pain or discomfort in the breast
  3. Swelling or redness in the breast area
  4. A feeling of fullness or heaviness in the breast
  5. Visible rippling or wrinkling of the implant
  6. Leaking of the implant material

If you are experiencing any of these symptoms, it is crucial to seek medical attention right away. Your healthcare provider may order imaging tests, such as an MRI or ultrasound, to confirm the diagnosis.

Dr.  Wiser showing free silicon left from a ruptured implant

Breast implant covered with capsule

Conclusion: Staying Vigilant About Breast Implant Safety

Breast implants can offer various benefits, but it is crucial to be aware of the potential risks and complications associated with the procedure. Breast rupture, capsular contracture, breast implant illness, and BIA-ALCL are four key concerns that women with breast implants should be vigilant about.

Regular screening for breast implant ruptures is essential in preventing further complications, such as infection or capsular contracture. While MRI is the most accurate imaging modality for detecting breast implant ruptures, ultrasound can also provide a quick and less expensive alternative.

If you are experiencing any symptoms of a breast implant rupture or have concerns about the health of your implants, it is crucial to seek medical attention right away. Your healthcare provider can help you determine the best course of action for detecting and treating any potential issues. Stay vigilant and proactive about your health to minimize the risks associated with breast implants.

Don't Hesitate to Get a Comprehensive Breast Implant Exam

If you have concerns about your breast implants or are experiencing any unusual symptoms, we invite you to schedule a comprehensive breast implant exam with Dr. Itay Wiser. Dr. Wiser is an experienced plastic and reconstructive surgeon who specializes in breast aesthetic and reconstructive surgery. With his expertise and dedication, he will provide a thorough assessment, including a detailed history taking, physical examination, and a state-of-the-art high-frequency ultrasound exam of the breast implants. This all-encompassing approach ensures that any potential issues are accurately detected and addressed, giving you peace of mind regarding the health and safety of your implants. Furthermore, Dr. Wiser can discuss and offer cutting-edge solutions to the patient's concerns and goals based on the findings, ensuring personalized and effective care. Don't let concerns about your breast implants go unaddressed – contact Dr. Itay Wiser today to schedule your comprehensive breast implant exam and take the first step towards ensuring your breast implants remain safe and healthy while achieving your desired aesthetic results.