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.
Melonie’s Blog: The Consultation
October 6th, 2009
When I arrived for my consultation, I felt a bit nervous but was immediately put at ease by Becky at the front desk. She collected my information and it was just a few minutes before I met the nurse and other staff. They were all very friendly, upbeat and informative. When it was time for me to meet Dr. Bashioum, I actually felt relaxed, having already met his staff first. As part of my research, I had read his patient blogs and I could see now that they were accurate about the staff. So I thought, this is going to go just like the other patients had described. My time with him was professional and comfortable. He asked a few questions, gave me a lot of information and took a very quick look at my breasts. Nothing at all uncomfortable or embarrassing. I was most impressed with his utmost concern being for my health, peace of mind and well-being. That is when I really decided he was the right doctor for me.
After we were finished the consultation, I was instructed to try on different size implants with the help of the nurse, to determine my new size. She did not offer any opinion and I felt comfortable choosing the size I thought looked best for me. She told me I could come back and re-size anytime I wanted before surgery, if I chose to do so. That day I chose the 475 cc, but felt I may want to go a little larger. I came back a week later with my boyfriend to re-size. I then chose the 500 cc and asked my boyfriend if he thought it looked right on me. He felt it looked good but said that it was most important that I was comfortable. I felt that I would most likely need time to adjust to whatever size I chose, but I liked the look of the 500 cc. So as of now, this is where I am at. My surgery is scheduled in 2 ½ weeks and I am feeling a mix of nervousness and excitement.
The surgery will be filmed for the blog, so check back to see how I’m feeling the morning of my surgery and hear what final decision I make regarding implant size.
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