I would really like to get a breast augmentation but I would also like to have children in the next 3 to 4 years. I have no children at present. Also, I have fibrocystic breasts and I get ultrasounds on my breasts yearly. So far, the results have been normal. Am I a good candidate for a breast augmentation? Thank you.
Breast Augmentation Even with Fibrocystic Breasts?
Doctor Answers (12)
Breast Augmentation Not Contraindicated in Fibrocystic Breast Disorder or Future Pregnancy
First of all, the latest statistic I read is that about 80% of women have some degree of Fibrocystic Breast Disorder (it is not a "disease"). Secondly, FCBD is not linked with breast cancer. While breast augmentation is not contraindicated in women with FCBD, there are a couple of factors you should consider. You did not mention if the reason you get an annual breast ultrasound is if you have palpable masses in your breasts. If a woman has a breast mass on exam, it is the burden of the physician to rule out cancer. Usually a mammogram is performed, but it may not be diagnostic unless "suspicious". In addition, very youthful breasts may not be the best way to image the breasts since they tend to be very "dense" on a mammogram. So an ultrasound is helpful to image dense breasts, and it particularly helpful to determine if a mass is"cystic" or "solid". If it is clearly a simple cyst, nothing has to be done, but often a needle aspiration is performed to remove fluid to minimize the size or symptoms of tenderness. A solid mass can be benign (fibroadenoma, more common in young women, not imperative to remove, but can grow to be large, so often removed in the operating room), but because of the possibility of something suspicious, it is usually biopsied, many times by way of a relatively non-invasive ultrasound guided needle aspiration procedure under local anesthesia.
What does this mean to you.....well, in part, it is related to your age. You didn't mention how old you are, but since you are having regular ultrasounds, presumably you are "young" and your breasts are "dense. You didn't mention that you have had any biopsies, so presumably all the masses in your breasts have been "simple cysts". You didn't mention your breast cancer risk, but unless you are at "high risk" (positive genetic testing or strong family history despite negative genetic testing), breast augmentation should not be a contraindication. Some plastic surgeons will tell you that saline implants under the muscle will be the ideal option for mammogram imaging, but I have discussed this with top-notch radiologists who inform me that as long as the implants are soft and mobile without capsule contracture, that it probably doesn't make any difference as long as the radiology tech is very good at the Eklund technique...the tech compresses the implants away from the breasts in order to get the most breast tissue on the xray cassette.
So your answer about FCBD is somewhat based on your answers to the other questions that I posed above. Of course, a thorough consult including your breast history and exam with a reputable plastic surgeon is imperative. Regarding future pregnancies.....no problem and in fact if you could normally breast feed, the surgery should not impair this, and pediatricians encourage it. There are no plastic surgery contraindications to breast feeding after breast augmentation. Long term, over the course of aging, gravity, loss of elasticity, weight fluctuations, pregnancies, breast feeding, and hormonal changes, your own natural breast tissue will change, your implant typically will not, with the exception of the possibility of capsule contracture and rupture. Good Luck!
Yours is not a straightforward situation
Serious fibrocystic disease makes the breasts harder to examine both mammographically and by palpation. Adding an implant to this situation has been frowned upon in the past and represents at least a relative contraindication to breast augmentation. As the other doctors have said, you should go to the best Board Certified plastic surgeon and seek their opinion after they examine you. They might even have you go speak with a radiologist and get their opinion. There are radiologists these days who specialize in imaging the breast. Also, if you have a history of breast cancer in your family tree plus bad fibrocystic disease, I would probably advise that you not have implants.
Breast Augmentation with Fibrocystic Disease
Many women with breast implants have some fibrocystic disease. The implants should be placed under the muscle for better viewing of the breast for the radiologist. However, it is important to consult with your gynecologist and whoever is following you for your fibrocystic disease, along with your board certified plastic surgeon to determine if you are a candidate for breast augmentation.
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Fibrocystic breasts, kids and implants
There are many patients like you who have fibrocystic breasts, (which is very common), and have children without any problems. You did not say if there is a history of breast cancer in your family. Even with breast implants in place, the breasts can be thoroughly examined. Ultrasounds, mammograms, MRI and other tests can be used after breast augmentation. The radiologist should perform an additional view of your breasts during a mammogram called the Eckland view. This helps to visualize the complete breast when implants are present.
All women should continue routine monitoring of their breasts after breast surgery. With the proper self breast exams, ultrasounds, mammograms and other tests as needed, the breasts can be closely monitored. You may also want to discuss this with your primary care physician and discuss your risk factors and get his/her recommendations.
Breast Augmentation Even with Fibrocystic Breasts
Implants have a tendency to obscure a portion of the breast tissue during mammography which may make suspicious lesions in your breast harder to detect, especially if you have a family history of breast cancer. I would also get an opinion from the Radiologist who reads your ultrasound and mammograms.
Firbrocystic disease and breast implants
Many patients with fibrocystic disease undergo breast augmentation. If you are concerned, then I would suggest seeing a general breast surgeon and seek out his/her opinion. A baseline mammogram may not be a bad idea first.
Fibrocystic disease and breast implants
I would discuss this in consultation with an oncologic breast surgeon. Furthermore, you may want to consider a baseline MRI, this is the most sensitive test for detecting breast disease. I would recommend that my patients be advised to undergo placement under the muscle rather than over. I have been told my by radiologist colleagues that it is easier to visualize the breast on mammograms when the implant is under the muscle.
Ask your breast doctor and plastic surgeon
You sound like the type of patient that needs teamwork. A plastic surgeon can advise how likely augmentation with implants is to work for you aesthetically. The doctor that follows your fibrocystic disease should be in a position to advise you whether she or he thinks implants would interfere with their regular evaluation. This might be your primary care doctor, ObGyn or a breast surgical oncologist.
Fibrocystic symptoms are quite common and don't preclude breast augmentation. However, a subset of patients have breasts that their doctors find challenging to evaluate. For these patients, I think it is important for the two of them to discuss the possible implant surgery and how to avoid problems in the future.
If you do not plan children in the immediate future, you could have augmentation sooner. Don't be surprised if your breasts change significantly through several pregnancies and breast-feeding.
Souldn't be much of a problem
Most women have some degree of fibrocystic disease. If you have them placed under the muscle there should be no problem with the mammogram. Implants will obscure ~3% of the breast tissue. Physical exam results should not be compromised however.
Only you can weigh the benefits and risks as they apply to you.
Assuming that baseline radiologic examinations are in order and maternal breast history is not in question augmentation should not be a problem. A 1 yr radiologic follow up is important as is good clinical oversight.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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