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Media Hype: Exploding Implants

October 15th, 2009

Most normal physical activities do not break breast implants.   However, extreme high speed sporting accidents can exert excess pressure, resulting in implant failure. This is a very rare occurence.  More commonly the accident just breaks the scar tissue around the implant.   The recent report of a woman breaking her implant while doing a stunt for reality TV proves this point.   Warning – this video clip contains harsh language.   I think  she just broke the scar tissue as it is impossible to tell immediately if the implant broke.   Her response is to the change in her breast which was hard before the fall and became softer after the impact.   Breaking the scar tissue from the outside is called closed capsulotomy.

I know I have mentioned it before, but all breast implants break or fail eventually.   This is no surprise, as all man made implant eventually fail.   Why?   Because stresses are repeatedly placed on the materials which lead to  stress fatigue.  Take a piece of wire and bend it back and forth many times.   You will first notice the wire becomes warm in the area that it is bending.   Keep bending it back and forth and it will eventually break.   This is the same process which goes on in the body.   Whether it is a heart valve, hip implant, pace maker or breast implant, this process continually goes on within the body and it eventually fails.

Of course, the length of time that it takes for an implant failure to occur is variable. The length of time that an implant lasts, is inversely related to the focus of the stress.   In the specific case of breast implants, they can develop a crease or fold once they are implanted.   This crease (like the wire) if it persists will result in implant failure.   Obviously  localized stresses  decrease the life expectancy of  an implant.  I generally tell patients breast implant failure is rare within ten years, but starts to increase between ten to twenty years after surgery.

The implications of various types of broken implant does varies.   Heart valves and pace maker failures can lead to serious or fatal consequences.   Joint replacement failures usually result in pain and a decreased ability to use the involved limb until corrective surgery is done.   Fortunately, breast implant failure does not lead to any immediate functional problems.   Saline implants, to their advantage, result  only in possible embarrassment when they deflate.  They also might interfere with mammograms more than when they are fully inflated.   Implants filled with silicone gel will eventually lead to changes in the natural scar tissue around the implant when they break.   These changes show up as firmness, tightness, tenderness, swelling, changes in breast shape or hard lump adjacent  to the  implant.   Silicone gel can become extravasated into the surrounding breast tissue in the  extreme cases.  For these reasons, the FDA recommends patients with silicone gel implants undergo MRI studies every other year after surgery, in an effort to detect silicone gel implant failure early.   Early detection allows corrective surgery  to be carried out before these clinical changes occur.

One other caveat needs to be mentioned.   I hope it is obvious to everyone that when the breast is penetrated with a needle or scalpel during surgery, the implant can be damaged or broken.   I have seen this on two occasions.   Fortunately both implants were saline implants.   Simply replacing the implants in these cases was all that was necessary.   Silicone gel implants damaged in this way might have required more surgery and they may have left the patient with mammogram changes.

Finally, mammograms should never be avoided for fear of breaking a breast implant.   Even though  considerable pressure  seems to be applied to the breast implant, it is  very, very difficult to actually break an implant in this way.  It happens only very rarely.

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Tara Reid: Poor Liposuction

October 14th, 2009

Photos of Tara Reid clearly reveal a poor result after liposuction or as she refers to it, “liposculpture.”  According to her, she chose to have the surgery because she wanted a six pack.   She was sold on the idea by her surgeon as she “shopped” around until she found someone who would do it for her.

Her appearance is consistent with removing as much fat as possible to reveal her rectus muscles.   Sadly, this usually results in scarring of the under surface of the skin (dermis) to the muscle.   Thus, causing the dimpled appearance of her tummy.  This is extremely difficult to fix!   Liposuction is not about how much you remove but how much you leave behind.   I would venture to say that Tara started out with the amount of fat which should have been left after liposuction!  So she was doomed to have this  result.  It is my guess that there will probably be a whole lot of “Photoshopping” or retouching of her photographs going on to  correct her abdomen for the Playboy cover she is  vying for!

I might add that she admits to having had liposuction of her abdomen because the poor result is so obvious.   However, it is unusual to do this one area alone.   A look at her inner and outer thighs shows asymmetry and depressions consistent with poor liposuction, as well.  Sometimes it’s better to accept minor imperfections, when the likelihood of creating significant defects persists by doing ill-advised cosmetic procedures.

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