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Of the breast plastic surgery procedures performed in 2006 in the US, 329,000 were for breast augmentation. For cosmetic breast plastic surgery in some countries, health insurers will only reimburse insertion of breast implants for clinical indications, meaning, congenital abnormalities, sex-reassignment surgery or breast reconstruction following a mastectomy. Today if you're considering breast plastic surgery, it's important to know all the pros and cons related to the type of procedure that you want.
In the mid 1980s, advances in manufacturing principles brought about elastomer-coated shells to decrease gel bleed. They are filled with a thicker, more cohesive gel. These implants are sold under restricted conditions in the US and Canada, but are widely used in other countries.
There are two primary types of breast implants: saline-filled and silicone-gel-filled implants. Since the saline implants are empty when they're surgically inserted, the scar is smaller than the scar for the silicone gel breast implants which come filled with silicone before they are placed.
It was mostly the silicone implants that were designed in the 1970s that were involved in the class-action lawsuits against Dow-Corning and many other manufacturers in the early 1990s. Compared to the silicone gel implants, saline implants are more likely to cause cosmetic problems likes rippling and wrinkling, and can be more noticeable to the eye or to the touch. There have been several types of breast implants developed other than the saline filled and silicone gel filled, including polypropylene string and soy oil, but these are not commonly used, if at all today. Leakage of oil into the body cavity during a rupture would not be good.
Saline-filled implants are the most common implant used in the US due to some of the restrictions on silicone implants, which may change; but they are seldom used in other countries.
Some of the local complications that can occur with breast implants include breast pain, post-op bleeding, fluid collection, surgical site infection, alterations in nipple sensation, interference with breast feeding, visible wrinkling, asymmetric appearance, wound dehiscence with potential implant exposure, thinning of the breast tissue, and disruption of the natural plane between the breasts.
Studies of the newer type saline-filled breast implants approved by the FDA in May 2000 showed rupture and deflation rates of 3-5% at three years and 7-10% at five years for breast augmentation patients. Thousands of women have claimed they have become ill from their breast implants; the complaints include neurological and rheumatological problems.
Recently the FDA recommended that MRIs should be considered to screen for silent rupture starting at about three years after implantation and then every two years thereafter. Rupture is one reason for needing to go back to surgery. Among the of rupture is damage during implantation or other surgical procedures, trauma to the chest, pressure from hard 'bear hugs', and the pressure from mammograms. Countries outside of the United States have not endorsed any routine MRI screening, and have taken the position that MRI's should be reserved only for cases involving suspected clinical rupture or to confirm mammographic or ultrasound studies that suggest there is a rupture.
Since the early 1990s, a number of independent reviewers have examined studies concerning any links between silicone gel breast implants and systemic diseases; the consensus of these reviews is that there is no clear evidence of a causal link between the implantation of silicone breast implants in breast plastic surgery and any systemic disease. One should always find out who is funding these studies and taken into consideration. One study reported that only 30% of ruptures, in patients with no symptoms, are accurately detected by experienced plastic surgeons, compared to 86% detected by MRI.
A contracture due to scar tissue is a complication that can be very painful and distort the appearance of the implanted breast and is quite common. It's important to remember that breast implants don't last a lifetime and at some time or other would need to be removed permanently or removed and replaced.
Although the general international consensus is that silicone implants in breast plastic surgery has not been shown to cause systemic illness, one must keep in mind that many women have reported a connection between the symptoms they're having and to their breast augmentation. As with any decision, make sure to weigh all the benefits and risks carefully before proceeding with any type of breast plastic surgery. If you decide to proceed, make sure you choose the best breast plastic surgeon based on some good research. Ask health professionals you know for referrals. Get references from the surgeon's patients.
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