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Overall complications and complexities associated with breast implants are capsular contracture or implant rupture, leakage, infection, cosmetic flaws, loss or increase of nipple sensation, bleeding or fluid accumulation (Eitenmiller, 2011).
Solutions and Outcomes
A Surveillance, Epidemiology and End-Results Breast Implant Surveillance Study conducted on women who received breast implants following mastectomy showed no survival disadvantage in those younger than 65 years of age (Le et al., 2005). The respondents were from San Francisco-Oakland, Seattle and Iowa between 1983 and 1989. The risk of mortality with breast implants following mastectomy is about half for those without implants. Breast implants continue to be the choice form of breast reconstruction among breast cancer patients. There has been no significant change in design despite an overall decrease in implant use among them (Le et al.).
The solution should be improvement rather than perfection (Eitenmiller, 2011). Complications in women undergoing reconstructive surgery after a diagnosis of breast cancer are substantially larger. Silicone implants have become available again but carry a higher failure rate than saline. The U.S. FDA still questions their long-term complications, however. Patients should then consider the potential complications and locate a board-certified physician, place costs aside, and plan for surgeries when deciding for breast augmentation (Eitenmiller).
Alternative to Silicone Gel Breast Implants
The major concern for allowing silicone gel breast implants on the market in 1992 was to keep the option open for mastectomy patients (Zuckerman, 2001). However, the majority of women getting mastectomies rather than breast-conserving surgery went down substantially. Instead, the preference for autologous tissue transfer far outnumbered implants. The FDA approved saline-filled breast implants in 2000. Since then, saline implants became the most sought-after alternative to silicone gel for implants after these were restricted in the early 1990s (Zuckerman).
The Institute of Medicine reported that local complications are the major concerns in breast implants (Zuckerman, 2001). These range from minor to serious. Infections can be easily managed or cause toxic shock syndrome, which in turn can result in gangrene or death. The most common complications are scarring, asymmetry, loss of sensation, pain, hardness, and the need for additional surgery. These are not fatal but affect quality of life and contradict the purpose of breast implant surgery (Zuckerman).
Breast implants can obscure the mammography of a tumor, thus interfere with the detection of breast cancer (Zuckerman, 2001). Implant can then delay the diagnosis. Mammography may be performed some way to minimize interference but 30% of cases will still be obscured. Capsular contracture is a common complexity with breast implants. Mammograms either get much less accurate or quite difficult to perform when there is capsular contracture. This is a widely acknowledged complication. The controversy is how often it happens and how serious. The likeliest treatment is to remove and replace the implants. Manufacturers provide research, which says that replacement is likely to cause more complications than the original ones. It also means additional risks and expense to the patient (Zuckerman).
While there has been no scientific evidence that shows implants cause breast cancer, the delay in diagnosis may require radical surgery or become fatal. A recent meta-analysis submitted by Dow Corning, a manufacturer of silicone for breast implants, concluded that women with implants were unlikelier to develop breast cancer than other women. Unlike the NCI study, published in 2000, the Dow Corning study did not include the largest study of women with breast implants. The NCI study showed neither an increase nor a decrease between women with implants and those without (Zuckerman).
Eitenmiller, H. (2011). What are the common problems with breast implants? eHow:
Demand Media. Retrieved on March 17, 2011 from http://www.ehow.com/about_5270789_common-problems-breast-implants.htm
Fenriman, I.S. And Hamed, H. (2006). Breast reconstruction. Journal of Internal
Clinical Practice: Blackwell Publishing. Retrieved on March 17, 2011 from http://www.medscape.com/viewarticle/529598
Le, G.M. et al. (2005). Breast implants following mastectomy in women with early-stage breast cancer: prevalence and impact on survival. Vol 7 (2) Breast Cancer Research:
BioMed Central Ltd. Retrieved on March 17, 2011 from http://www.medscape.com/viewarticle/497875
Shons, a.R. et al. (2001). Postmastectomy breast reconstruction: current techniques.
Vol 8 (5) Cancer Control: H. Lee Moffit Cancer Center and Research Institute, Inc.
Zuckerman, D. (2001). Are breast implants safe? General Medicine: Medscape.
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