Understanding Breast Implants: Types and Safety

Visual of a breast implant
Visual of a breast implant

Breast augmentation surgery is a common procedure sought by many women for various reasons, ranging from cosmetic enhancements to reconstruction after mastectomy. One of the critical decisions in this process is choosing the right type of breast implants. Your surgeon will guide and recommend the right implant for you but knowing more about breast implants can help inform you as to what to ask and what options might be available to you. With advancements in medical technology, there are several options available, each with its unique features and safety considerations. In this article, we will explore the different types of breast implants and address common concerns regarding their safety.

Types of Breast Implants

  1. Silicone Gel Implants:
  • Filled with a silicone gel that closely mimics the feel of natural breast tissue.
  • Available in various shapes and consistencies, including round and teardrop.
  • Generally believed to provide a more natural appearance and texture.
  1. Saline Implants:
  • Filled with sterile saline solution (saltwater) after insertion into the breast.
  • Require a smaller incision compared to silicone implants.
  • If ruptured, saline is harmlessly absorbed by the body.
  • These are not routinely used in the UK

3.Structured Implants:

  • Contains an inner structure or multiple chambers to control the movement of the filling material.
  • Designed to provide enhanced shape retention and reduce the risk of rippling or wrinkling.

4.Gummy Bear Implants (Form-Stable Implants):

  • Made of a thicker silicone gel that maintains its shape even if the outer shell is ruptured.
  • Offer a more stable form and are less likely to ripple or shift within the breast.
  1. Fat Transfer (Autologous) Implants:
  • Involves using liposuction to harvest fat from other areas of the body and injecting it into the breasts.
  • Provides a natural alternative using the patient’s tissue.
  • Typically used for small volume enhancements.

6.Polyurethane or microtextured (smooth)implants

  • This refers to the shell of the implant.  Microtextured or smooth implants are most commonly used with much hardier shells resistant to rupture with modern day implants only replaced if ruptured not routinely with a presumed lifespan
  • Polyurethene coated implants maybe recommended for their resistance to capsular contracture which is a complication that can occur with age of implants that can cause pain and require reoperation (see below)

Safety Concerns and FAQs

1. Are breast implants safe?

  • Breast implants approved by regulatory bodies such as the FDA in the US and MHRA in the UK are generally considered safe. However, like any surgical procedure, there are risks involved, including infection, implant rupture, and changes in breast sensation.

2. Do breast implants affect mammograms?

  • There is no evidence that having breast implants lessens the effectiveness of mammograms however certain adjustments need to be made when taking the mammogram. It’s essential to inform the radiologist about your implants so they can take additional views or use specific techniques to ensure accurate results.

3. What are the risks of implant rupture?

  • Rupture can occur in both silicone and saline implants, although the consequences differ. Saline implant rupture results in deflation and noticeable changes in breast size, while silicone implant rupture may be silent, requiring imaging tests to detect. If there is a proven silicone implant rupture then your breast surgeon will advise you on the course of action required which will include removing the implants.

4. How long do breast implants last?

  • While breast implants are not considered lifetime devices, they are designed to be long-lasting. However, they may need to be replaced or removed due to complications such as rupture, capsular contracture, or changes in aesthetic preferences.

5. What is capsular contracture, and how common is it?

  • Capsular contracture occurs when the scar tissue (capsule) that naturally forms around the implant becomes thickened and constrictive, causing the breast to feel firm or distorted. While it can occur in any type of implant, its incidence varies, with silicone implants generally having lower rates compared to saline implants and lower still with polyurethane implants.

Conclusion

Choosing the right type of breast implant involves considering factors such as desired aesthetic outcome, body type personal preference and ongoing cancer treatment. While all breast implants have undergone rigorous testing for safety and efficacy, it’s essential to discuss your concerns and expectations with a qualified plastic or breast surgeon. By understanding the different types of implants and their associated risks, you can ensure you have the relevant knowledge to have an informed discussion with your surgeon to make the choice that best suits your needs and enhances your confidence and well-being.

Mr Senthurun (Seni) Mylvaganam

Consultant Oncoplastic Breast Surgeon

www.drseni.com

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FAQ’s

Breast surgery as any surgery is not without risk. These risks and the relative chance of them happening for you will differ dependent on the type of surgery you have and also personal risk factors. Risks of breast surgery can be early risks related to the surgery itself or longer term risks such as cosmetic changes related to ageing.

Infection and poor wound healing are a risk in all breast procedures whether it is for breast cancer or for cosmetic reasons. Cosmetic surgery has a lower risk of this but it is increased if you are a smoker or have other medical problems which may effect healing such as diabetes. Every breast procedure will have a long list of possible risks or complications however most of them can be quite rare.

Your surgeon will be able to guide you through the individual risks for your chosen procedure explaining about likelihood of occurrence and what that could mean for you if the complication occurs.

This can be a difficult question to answer. In the cosmetic setting your surgeon will listen to you about what you wish to achieve focusing on shape and volume. They will then examine and assess your chest frame to determine what range of implants are suitable for you to compliment your body shape without risk of long term poor cosmetic results.

Implants vary by brand, surface texture, volume and projection. The choices available within each of these categories can be extensive. The right implant for you will be based on a collaborative discussion between you and your surgeon to select the right implant, volume, shape and projection to be the best fit to meet your cosmetic needs.

Same day cosmetic surgery is generally very safe. Your surgeon will discuss with you specific risks which will be related to the surgery that is to be undertaken and the individual risks that may be more specific to you. This can often be related to any other medical conditions you have or if you are a smoker.

Following surgery you are observed for 2-4 hours afterwards to ensure you have recovered from the anaesthetic and there are no immediate post operative complications. If you are then deemed fit to be discharged you will be able to leave with further post operative instructions to guide you at home and also contact details should you experience any problems at home and need further medical advice. You will be required to have a responsible adult stay with you for the first night after surgery to be eligible to be discharged on the same day of your surgery.

The purpose of cosmetic and reconstructive surgery is different. Cosmetic surgery has a goal of improving the cosmetic appearance by complimenting and modifying the shape and/or size of your natural breasts. Reconstructive surgery is primarily considered for patients who may require or have a mastectomy(removal of all breast tissue). This can be for a number of reasons but primarily is for the treatment of breast cancer or risk reduction if patients have a gene defect making them much more at risk of developing breast cancer. Reconstructive surgery involves the recreating of a breast mound and shape. The cosmetic goals in reconstructive surgery can be quite different to cosmetic breast surgery due to the effects of cancer treatments and the loss of all breast tissue often preventing an optimal natural appearance to be achieved.

Both types of surgery can use implants and fat grafting but reconstructive surgery can also be undertaken by moving your own tissue from another area to recreate the breast.

If you are experiencing a breast symptom such as a new lump, skin or nipple change, nipple discharge, breast shape change, armpit lumps or breast/chest swelling in men then this clinic appointment will aim to address these and other breast symptoms. I will undertake a detailed assessment of the symptoms, screen for the need for genetic risk assessment and examine you. Based on this I will give you a clear explanation of that assessment.

I will inform you as to any diagnosis reached or the need for any imaging, which could be a breast ultrasound or mammogram to help reach that diagnosis. This may also be complimented by a tissue biopsy to confirm any diagnosis. Following any diagnosis I will discuss with you a plan of treatment or reassurance as necessary.

Breast symptoms are extremely common and can range from noticing a difference in the appearance or texture of your breasts to new lumps, nipple changes and breast pain. All breast symptoms should be reviewed by either your GP or a breast surgeon. However this does not mean to say that your symptom is likely to represent a worrying change such as cancer.

MOST breast symptoms are either the result of a normal variation in the tissues that comprise your breast or to a family of conditions that are collectively called benign breast disease. In my breast reassurance clinic I will be able to assess you and provide a diagnosis and explanation for your symptoms or if necessary, further assess the symptoms if a cancer is suspected. It is much more likely your breast symptoms are not due to breast cancer but please do be assessed for any new symptoms.

Choosing to have breast augmentation is a very personal decision. Your surgeon should guide you through this process. By doing this they should help you to decide firstly whether it is right for you and then guide you through your vision for the final look and how to achieve it. I always aim to really understand what the final desired appearance is wanted right up to the smallest detail. We discuss this based on the shape including cleavage, appearance in and out of clothes and then also volume. Following this discussion to achieve your look we may also discuss performing a small uplift as well as the use of implants.

I will always be honest about what can be expected and whether your vision of the final look is possible and responsible to achieve whilst respecting your body shape and frame. A library of my work will also be available for you to view. Beyond this it is also crucial that your surgeon discusses with you the potential risks of the surgery which should include short term and what may happen in the long term. With this entire discussion you will develop a rapport and relationship with your surgeon. You can then decide if that surgeon is the right one for you or not.

Breast augmentation surgery can be undertaken as a day case procedure. Hence you can go home the same day once you have had a period of observation after surgery. You will be fitted with a surgical bra and a binder which can be purchased by yourself or provided at the hospital. The binder provides gentle pressure from above the implants ensuring they remain in the optimal position whilst healing occurs. Please aim for about 4-6 weeks of recovery before getting back to anything strenuous such as the gym or long runs. If returning to work this can be done after 1-2 weeks but ensure you only undertake light manual labour activities.

I will ask you to wear the surgical bra as much each day and night as possible for 6 weeks to provide the best cosmetic result. Upon review during your recovery I will inform you as to when to remove the binder.

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Treatments

Breast Reassurance

Breast symptom assessment utilising the national standard of triple assessment (clinical hist...

Breast Cancer Care

Treatment of breast cancer including a full range of oncoplastic and breast reconstruction techniques.

Cosmetic Breast Surgery

Surgery to change the appearance of your breasts adjusting volume, shape and cleavage.