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13.07.2015
More than 300,000 women received industrial-grade silicone in their implants from French implant manufacturer, Poly Implant Prosthesis. With the practice of 'plastic surgery tourism' sending many overseas for the same cosmetic procedures but at cheaper prices, many women affected are from the U.S. CONNECT WITH FT: Like us on Facebook, follow us on Twitter and sign up for our newsletter for the latest news and features from fashion. The formation and consequences of capsular silicone granulomas related to breast implants are not well described in the literature but leakage of silicone is perceived to play an essential role.
If a low-grade infection combined with rupture of implants causes granuloma formation, these granulomas may in time become calcified and could possibly cause damage to any new implants inserted. A 59-year old woman was referred to our department for removal of bilaterally ruptured silicone breast implants. As stated above, though the exact biodurability of silicone implants are not known, studies suggest up to as much as 55% implant rupture after 10 years. As described in this commentary, both women presented calcified granulomas in the fibrous capsule formed around the old implants. When tested, the sharp edges of the calcified granuloma were easily able to cut into the implants.
With this case report, we seek to raise awareness of this potential complication and the possible benefits of capsulectomy including all calcified elements when replacing silicone breast implants. Join tens of thousands of doctors, health professionals and patients who receive our newsletters. Augmentation mammoplasty, or breast augmentation is a surgical procedure to increase the size, shape or fullness of a woman's breasts.
Restore the breast(s) after surgery as treatment for breast cancer or some other condition or event that affected the size and shape of the breast.
Breast enlargement boosts self-esteem - women usually experience a significant boost in self-esteem and positive feelings about their sexuality after undergoing breast enlargement, researchers from the University of Florida reported in Plastic Surgery Nursing.
The authors emphasized that although plastic surgery is not a panacea for feelings of sexual attractiveness or self-worth, it is important for health-care professionals to understand the psychological benefits of these procedures. According to an article published in Plastic and Reconstructive Surgery (May 2013 issue), 98% of women who underwent breast augmentation surgery said the results met their expectations. According to the American Society of Plastic Surgeons, there were 307,190 breast augmentations procedures in the USA in 2011, as well as 22,271 breast implant removals. Women with breast implants can still breastfeed - no part of the implant gets into the breast milk. A breast implant is a medical prosthesis that is placed inside the breast to augment, reconstruct or create the physical form of the breast.
If this type of implant leaks, the solution will be absorbed and expelled by the body naturally. Silicone implants - filled with a viscous silicone gel which is held within an elastomer silicone shell. If a silicone-filled implant leaks, the gel will either stay in the shell or escape into the breast implant pocket.
Although the US FDA recommends regular follow-up MRI scans for women with silicone implants, a study published in Plastic and Reconstructive Surgery (March 2011 issue) says there are significant flaws supporting this recommendation. Alternative composite implants - these may be filled with polypropylene string, soy oil or some other material. The choice of which incision to use depends on several factors, including the degree of enlargement, the patient's anatomy, the type of implant, and surgeon-patient preference. A submammary (subglandular) placement - behind the breast tissue, over the pectoral muscle. Techniques used today for placing breast implants have significantly improved recovery times. The surgeon closes the incisions with layered sutures (stitches) in the breast tissue, and with skin adhesives, sutures and surgical tape to close the skin and keep it closed. Nobody should drive immediately after anesthesia, because it affects coordinating and reasoning skills for at least 24 hours. In most cases, the woman should not engage in strenuous physical activities for about six weeks. Thanks to more advanced techniques today, including submuscular and subglandular placements, recovery times have improved considerably. It is important to follow the surgeon's advice regarding what type of bra to wear, and when to wear it. If the surgeon used sutures that do not dissolve, or placed drainage tubes near the breasts, the patient will need a follow-up appointment to have them removed. Women whose implants were inserted beneath the chest muscles (submuscular placement) will take longer to recover, and will also experience slightly more pain, because of the healing of the incisions to the chest muscles. Anaplastic large cell lymphoma (ALCL) - the US FDA (Food and Drug Administration) carried out a review in 2011 which found that women with saline and silicone gas-filled breast implants have a higher risk of developing anaplastic large cell lymphoma. The FDA reported in 2011 that 20% of women who received silicone gel-filled breast implants had to have them removed within ten years. In order to be fully informed, and also for the surgeon to completely understand the needs of the patient, you should make a list of questions.


What do you recommend for me, regarding placement site, incision site, surface texturing, size and shape? It is important that the surgeon you chose is licensed and recognized by a competent professional plastic surgery association of your country. In the USA, the surgeon should be a member of the American Society of Plastic Surgeons (ASPS).
Has done five years of surgical training, which includes at least two years in plastic surgery. Has experience and professional training in all plastic surgery procedures, including face, body and breast reconstruction. If you are in the UK, you should seek out a plastic surgeon certified by The British Association of Aesthetic Plastic Surgeons. The Canadian Society for Aesthetic Plastic Surgery is the only recognized professional body of Canadian plastic surgeons.
The Australian Society of Plastic Surgeons Inc (ASPS) is the peak body for Specialist Plastic Surgeons (both reconstructive and cosmetic). Sources: American Society of Plastic Surgeons, Youtube, Wikipedia, FDA, Medical News Today archives.
Please use one of the following formats to cite this article in your essay, paper or report:MLANordqvist, Christian.
For any corrections of factual information, or to contact our editorial team, please see our contact page. Please note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. A facelift is a surgical procedure that is typically used to give a more youthful appearance to the face.
Our guide to liposuction, the cosmetic surgery that 'sucks' fat from various parts of the body. One of the more important decision you will have to make when proceeding with a breast augmentation is the type of incision you would like. All rights reserved.Your Privacy RightsThe material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of Fashion Times. BackgroundThe local formation of calcified silicone granulomas (CSG) and the consequences following are not well described in the literature and the mechanisms behind are not fully understood. To our knowledge, nothing has been described as to the potential side effects of calcified silicone granuloma (CSG) formation due to breast implants. Medical history included a cerebral thrombus 7 years previously without significant sequelae but otherwise healthy. Case 2A 52-year old female was also referred for removal of bilaterally ruptured silicone breast implants. DiscussionResult from the American Society of Plastic Surgeons procedural statistics show a 45% increase in cosmetic breast augmentation operation from 2001 to 2011 [7].
With that in mind, it is likely that an increasing number of patients having breast augmentations performed will need an exchange of implants one or several times during their lifespan. In both cases the patients had not had breast implants prior to the ones removed at our department and the source of the CSG is believed to have been implant rupture [2]. We suggest that further studies be made to shed light upon this potential complication in order to improve surgical techniques as well as patient information.
Kenneth Finnerup, consultant plastic surgeon, Aalborg University Hospital, for general support. The surgeon places silicone, saline or alternative composite breast implants under the chest muscles or breast tissue. Swanson reported that the average patient was 34 years old, and most opted for the 390 cc saline-filled breast plant under the muscle. The inside of the implant is filled either with salt water (saline solution), silicone gel, or a composite of alternative substances. The latest one is made of a semi-solid gel that has virtually completely eliminated silicone gel bleed (filler leakage) and silicone migration from the breast to other parts of the body, according to manufacturers. When placed here the patient may take slightly longer to recover, compared to subglandular placement, and may also experience a little more post-operative pain. There will be some swelling caused by the surgery, which will resolve within a couple of weeks. Ideally, the patient should have a relative or friend stay with them for a day if they go home soon after the operation.
She will probably be encouraged to do some post-operative exercises, such as flex and move her arms to relieve pain and discomfort.
If the patient experiences chest pains, unusual heart beats, or shortness of breath, the surgeon needs to be told straight away. Learn about the origin, how it works, what can be treated with this drug, the procedure involved and side effects.
The incision will allow your surgeon to have direct access to create the pocket that your implant will be placed in. We describe two cases where women were referred to our department for removal of silicone breast implants due to rupture.


There are theories that silicone leakage combined with chronic low-grade infection may play a role or that granuloma formation is the result of the foreign body response [1, 2].
The patient had no reported intake of prescription medicine or dietary supplements, but smoked 10-15 cigarettes daily.
The results from 2011 also show a 4% increase over one year in surgeries performed on girls under the age of 19 [8].
Thus; if left in a breast after an exchange of implants could CSG potentially damage and ultimately rupture a new implant? Eric Swanson, a plastic surgeon who conducted the prospective outcome study, added that women also reported improvements in quality of life and self-esteem after their procedure. These implants can be filled with different amounts of saline solution, which may affect the feel, firmness and shape of the breast. Patients choosing this type of implant should carry out more regular checks with their doctor compared to those on saline solution implants. As the swelling dies down and the incision lines fade, the patient will have a better idea of whether the procedure met her expectations. Since Plastic Surgery is elective, you can have it anytime of the year, whenever it fits your schedule best.
At both surgeries, the patients presented with hard, brittle plaques on the inside of the fibrous capsule formed around the implants.
The biodurability of silicone implants are not known but studies have suggested rupture rates varying from 8-55% at year 10 after implantation [3, 4, 5]. The breast augmentation surgery had been performed 25 years prior for cosmetic reasons and the patient had not previous had breast implants. The breast augmentation had been performed 22 years prior for cosmetic reasons and the patient were carrying first implants. When comparing with other causes of implant rupture, CSG potentially damaging effect may most likely only play a minor role in implant rupture but is surgically preventable.
Depending on the type of implant, the degree of enlargement desired, your particular anatomy, and patient-surgeon preference your options may be limited. A plaque was removed from the capsule of the first patient and histopathological examination confirmed it to be a calcified silicone granuloma. Studies have shown a varying number of causes of implant rupture including closed capsulotomy, breast compression during mammography and rupture secondary to trauma (motor-vehicle accidents, falls etc.). The patient had symptoms in the form of pain and the feeling of liquid moving in her breasts. In this case the implant rupture was a coincidental finding during a routine screening for breast cancer and was later confirmed by ultrasound. Even with the advances in durability of implants, rupture and granuloma formation is still a concern. Each incision will be closed by layered sutures along the breast tissue, then skin adhesive or surgical tape will be applied for a better hold and recovery. During surgery on the second patient, a similar plaque was excised and the sharp edges were seen to easily cut through the surface of the freshly removed implant.
A case report by Lahiri et al describes locoregional silicone spread after high cohesive gel implant rupture with silicone granuloma formation in capsule [9]. When you go in for your consultation, you and your doctor will discuss what will be the best solution for you. Procedural statistics from the American Society of Plastic Surgeons (ASPS) show a considerable increase in cosmetic breast augmentations performed, as well as a growing tendency for operations performed on younger patients. When surgically removed the implants were found to be ruptured with considerable silicone leakage.
One of the plaques was excised and it proved to easily cut into the removed implant with resulting silicone leakage, see Figure 3. Consequently it is probable that an increasing number of patients in the future will need operation to change implants. On the inside of the fibrous capsule formed around the implants, circular hard plaques were noticed, see Figure 1. This patient also underwent surgery without insertion of new implants and had an uneventful recovery.
With this commentary we wish to draw attention to the possible detrimental effect of calcified silicone granulomas on silicone implants when left in a breast after changing of implants. Further studies on the incidence and potential side effects of calcified silicone granulomas are needed. This examination included chemical fixation with formaldehyde and decalcification prior to embedding in paraffin wax. The textures of the granulomas were hard, brittle and decidedly sharp at the ends, see Figure 2.
As the operation was performed in the Danish National Health Care System, new implants were not considered.



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