Breast Prostheses

Posted on February 28, 2008
Filed Under Woman |

What are they and what are they used?
Breast prostheses are devices that are implanted in the breast or breasts of women for two main reasons: as an aesthetic, to increase the breast in those women who want larger breasts have a few (80% of cases), and rebuild the breast in those women who have a breast removed for suffering breast cancer.

Types of prostheses
There are 3 basic types of breast prostheses: saline-filled prosthesis, a prosthesis filled with silicone gel-filled and other alternatives such as soybean oil.

Breast prostheses may vary on the surface of the envelope (smooth or rough), form (round or other shapes), the profile (which stands), the volume (or size) and thickness of the casing.

The key parts of breast prosthesis are:
* The jacket or outer layer
* The fill material
* A patch covering the whole manufacturing.

Concerning the design of the casing, while the majority of prostheses have only one outer layer (the shell itself), some prostheses has a double envelope (one inside the other). Regarding the filling material, some prostheses are manufactured with a fixed volume of a filler material; some are filled during surgery and to adjust the volume of filler material after the operation.

In prostheses with silicone gel-filled silicone the term refers to a family of silicon organic compounds chemically related and derived from the silica. Medicine, silicone has been used extensively as a small quantity of this substance can be found in total joint replacements (knee, hip, etc…), Heart valves and even artificial teats of feeding bottles for infants. However, increased use of medical liquid compound, the siloxane polidimetil, is done with breast prostheses that were developed for over 40 years.

What is the surgery?
The surgery, but can be done with local anesthesia and sedation, is preferable performed under general anesthesia. An incision is made at the lower end of the nipple-areola, or in the groove underneath the breast or even in the fold of the armpit and the prosthesis is inserted to place either under the mammary gland itself, or beneath the muscle chest which is in turn under the gland. The choice of technique depends on the discretion of the plastic surgeon. The hospital stay is usually 24 to 36 hours.

What complications can arise?
It is important to bear in mind that most women who have surgery for breast prostheses may suffer from local complications such as pain, capsular contracture (formation of scar tissue around the prosthesis or that tightens squeeze) or the prosthesis or breakage deflate. In many cases, require non-surgical treatments or surgical reintervention to treat these complications.

Local complications of surgery for implantation of breast prostheses are therefore common and is the first concern regarding the safety of the intervention. In addition, complications accumulate over the life of the prosthesis that should also know, do not last a lifetime. Finally, the women received information about possible local complications of this type of surgery is crucial to make the final decision to operate or not.

There is a long list of local complications of this type of intervention:
* Asymmetry of the breasts
* Pain in the same
* Breast tissue atrophy
* Calcifications or calcium deposits in breasts
* Capsular contracture
* Chest wall deformity
* Delayed healing or formation of large scars or keloids
* Or output extrusion of the prosthesis
* Galactorrhea or secretion of milk by nipple
* Hematoma, granuloma or complication of the wound
* Infections
* Irritation or inflammation
* Malpositions or displacement of the prosthesis
* Death or necrosis of tissues
* Sensory changes in the breast or nipple
* Rupture of the prosthesis, or it will deflate or deflated
Seroma *
* Curls or wrinkles in the skin
* Unsatisfactory aesthetic results by size or style, etc.

Of these, the most important because of their frequency and consequences are breast pain, capsular contracture the aforementioned changes in sensation in the breast or the nipple and the rupture of the prosthesis or that it will deflate or deflated.

Some of these local complications require surgery and reoperation in some cases, removal of the prosthesis, with subsequent complications aesthetic (dimples and curls or wrinkles in the skin, loosening or falling of the chest, etc.).. The frequency of these complications is aesthetic in 12-14% at 5 years when the intervention is to increase the size of the chest and 28-30% at 5 years when breast reconstruction is, as the average time for removal the prosthesis of 11.5 years.

Women must be subjected to multiple reoperations to improve the appearance of the breasts, remove the prosthesis deflated or repair broken or other local complications may end the process with a clearly unsatisfactory aesthetic result, with all that entails.

It has been found that one in four women with breast prostheses had a local complications requiring surgical reintervention during the first 5 years after implantation. In the same way it found that one in 3 women who received breast prostheses to reconstruct their breasts be required reoperations within the next 5 years and 1 in 8 women who were operated to enhance your breasts had to be within the reoperations following 5 years.

Is there any risk to health caused by prostheses?
Some women carrying breast prostheses have developed health problems they believe are related to their prostheses, but the majority of medical and scientific studies have failed to demonstrate such an association. Most of the health concerns related to breast prostheses are believed caused by a reaction of the body against a foreign material such as silicone.

Of the various diseases that have tried to connect with two breast prostheses: breast cancer and a disease called rheumatic connective tissue disease that includes other diseases such as rheumatoid arthritis, systemic lupus erythematosus or scleroderma among others, or disorders (signs or symptoms) related.

Today we know that breast cancer is more common in women with breast prostheses compared to those that do not carry. Multiple scientific studies have corroborated it.

What does seem clear is that breast prostheses may interfere with early detection of breast cancer to make and interpret a mammogram. Compression of the breast during this test may cause the rupture of the prosthesis or that it will deflate. The best test to detect this problem in the silicone prosthesis is nuclear magnetic resonance.

Various studies have been unable to establish a clear cause-effect relationship between breast prostheses and connective tissue disease, so now you can not talk about breast prostheses that cause such diseases.

Considerations before getting breast prosthesis
* Most women who get breast prostheses suffer some local complications that may require subsequent medical or surgical treatment (reoperation or removal of the prosthesis). Breast prostheses do not last a lifetime. They often require long-term monitoring and re-operated for treatment of complications.
* Being considered an aesthetic treatment, not part of the social security benefits in Spain so the intervention is not funded. Even many private insurers cover it. In case of need for reconstruction after breast cancer surgery is considered a medical treatment and is funded by Social Security.
* It is important to know the real capacity of the final result. No surgeon will give absolute guarantees that its result will be similar to other women who have achieved a great success. The results of your particular case will depend on many individual factors such as general health (including age), the structure of the thoracic cavity, the shape and position of the breast and nipple, skin texture, healing capacity (which may be delayed in case of previous radiotherapy or chemotherapy, alcohol, snuff, drugs, etc..) tendency to bleed, prior breast surgery, skills and experience of the surgical team, type of surgery, type and size of the prosthesis.
* Many of the changes in the breasts after implant prosthesis can be aesthetically undesirable and irreversible. With the subsequent removal of the prosthesis may appear dimples, wrinkles or loosening of the breasts, loss of breast tissue or other undesirable aesthetic changes.
* Women with prostheses should follow the same program for early detection of breast cancer through mammography. There is a risk that breast implants deflate or break during this test.
* Other hazards are the goals late in the detection of breast cancer and pain or discomfort that may be after surgery.

Despite the controversy, there is no scientific evidence linking silicone breast prostheses with different diseases such as breast cancer or connective tissue.

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