Breast implants are medical devices that are surgically inserted into the breast tissue or beneath the chest muscle to enhance the size, shape, and appearance of a woman’s breasts. These implants can be used for cosmetic reasons (known as breast augmentation), reconstructive purposes (post-mastectomy or injury), or as part of gender affirming surgery for transgender individuals.
There are two primary types of breast implants – saline and silicone.
- Saline Breast Implants: These implants have a silicone outer shell filled with sterile salt water, or saline. The saline solution can be adjusted, allowing for the surgeon to modify the size and shape of the implant during surgery. Saline implants are available to women aged 18 and older for breast augmentation, and to women of any age for breast reconstruction.
- Silicone Breast Implants: These implants are made of a silicone outer shell filled with silicone gel, which mimics the feel of natural breast tissue more closely than saline implants. Silicone implants are available to women aged 22 and older for breast augmentation, and to women of any age for breast reconstruction. Due to concerns about the safety of silicone implants, the United States Food and Drug Administration (FDA) had placed a moratorium on their use from 1992 to 2006. The ban was lifted after extensive research and safety reviews.
Breast implant surgery is usually performed under general anesthesia and involves the following steps:
- Preoperative Consultation: The patient and surgeon will discuss the goals of the surgery, the type of implant to be used, and any potential risks and complications associated with the procedure.
- Incision: The surgeon will make an incision, typically either around the nipple (periareolar), in the breast crease (inframammary), or in the underarm area (axillary). The location of the incision is based on factors such as the type of implant, the patient’s anatomy, and the desired outcome.
- Implant Placement: The breast implant is then inserted either subglandularly (between the breast tissue and the chest muscle) or submuscularly (beneath the chest muscle). The placement depends on the patient’s preferences, body type, and the type of implant.
- Closure of Incisions: Once the implant is securely in place, the surgeon will close the incisions using sutures, adhesive, or surgical tape, and a sterile dressing will be applied to protect the area.
- Recovery: The patient will be monitored in a recovery area before being allowed to go home. Recovery time varies, but most patients can return to work and light activities within one to two weeks. Strenuous activities and exercise should be avoided for several weeks to allow for proper healing.
Potential Risks and Complications
While breast implants are generally considered safe, as with any surgical procedure, there are potential risks and complications. Some of these include:
- Infection: An infection may occur after surgery, and in some cases, the implant may need to be removed temporarily until the infection has been treated.
- Capsular Contracture: This occurs when the tissue surrounding the implant tightens, causing the breast to feel firm and potentially painful. In some cases, this may require additional surgery to remove or replace the implant.
- Rupture or Leakage: Breast implants can rupture or leak due to damage, aging, or manufacturing defects. Saline implants typically deflate quickly upon rupture, while silicone implant leaks may be more difficult to detect. Additional surgery may be needed to address this issue.
- Changes in Sensation: Some patients may experience changes in breast or nipple sensation after surgery, which can be temporary or permanent.
- Aesthetic Concerns: Some patients may be dissatisfied with the appearance of their implants, particularly if there is asymmetry, rippling, or visible scarring.
- Implant Displacement or Migration: The implant may shift from its intended position or rotate, requiring additional surgery.
Lastly, it is important to note that breast implants are not considered lifetime devices. They may need to be replaced or removed after a certain number of years, typically ranging from 10 to 20 years, or if complications arise. Regular checkups and monitoring are necessary to ensure the continued safety and effectiveness of the implants.