My daughter is 17 1/2 and her right breast is quite a bit smaller than her left and is going to have an adjustable breast implant augumentation in the right breast to get it symetric to the other larger breast. The doctor stated he would leave the fill port in so we could make adjustments in case she grows some more due to her age. He recommended leaving in for 4+ years until she was 22 years old and could replace with silicone gel implants. Is it safe to leave fill port in this long?
Is It Safe to Leave in Fill Ports for 4 Years or More?
Doctor Answers (12)
Breast Implants and Ports?
Thank you for the question.
As long as you are able to follow-up with your surgeon, leaving the port and for several years should not be a problem. If your plastic surgeon has a demonstrable experience level doing what he is proposing then your daughter is likely in good hands.
The implant companies do not recommed that the ports remain permenantly. However, there is no threat to your daughter's health with the port in place. It is a source for potential leaking, of saline, but this is infrequent and does leave the option of adjustability.
Leaving fill port in for 4 years
I see no problem with leaving the fill port in for 4 years. My experience has been that the problem with adjustable implants is that over time they tend to deflate. There are other options available including temporary expander placement followed by permanent implant. Another possibility is the Brava device which would stretch out the skin externally. This is a bit controversial as far as effectiveness is concerned. Photos would be very helpful in order to give a more specific recommendation.
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While there is certainly nothing wrong with leaving a fill port and tissue expander for 4+ years, if she is at the stage where her breasts are not significantly changing in size, she could have the expander and fill port removed now and have the silicone gel implants placed (off label). If she has changes in her breast size down the road, she may then require revision. See other topic today on off label use of silicone breast implants
Silicone Implants in an 18 year-old are NOT illegal!
Why not have the appropriate expander surgery, outpatient expansion, adjustments if necessary, and (once no further growth is verified) exchange for silicone gel implants when she is ready, regardless of her age?
Or, if your daughter has reached her final adult growth, simply choose the proper size silicone for best symmetry (absolute symmetry is both impossible and unrealistic) and skip the "automatic" second operation in favor of (probably) one operation, and still leaving the door open for a second revisional surgery (only if needed).
The FDA, as of November 2006, has approved the use of silicone gel breast implants for elective first-time cosmetic breast enlargement in women over the age of 22. Use of silicone gel implants in women under age 22 would be considered "off-label" use, much as Botox used to treat "crow's feet" periorbital wrinkles (the FDA approves Botox Cosmetic only for the treatment of glabellar frown lines--other areas are considered "off-label" use).
I support the right of properly-informed women between the ages of 18 and 22 to request and consent to the use of the implants of their choice.
(Just as I treat crow's feet with Botox!)
Properly-informed women who educate themselves about the pros and cons of silicone gel implants and saline-filled implants should be capable of deciding what implants they prefer, and I am happy to help provide the science. You should read my article (found on the About tab on my profile page) titled "Are Silicone Breast Implants Safe?" or click on the link below for more information about implant choices. Best wishes!
Adjustable Implants for Expansion/Augmentation
If your plastic surgeon is using a tissue expander that is designed to also be used as an implant, it seems safe to leave the valve in place indefinately. The only risk would be if she is very thin and the pressure of the port caused it to erode through the skin. This is very unlikely if there is good muscle coverage. However, I am not sure why a 4 year wait is necessary. Unless your daughter reached puberty at an unusually late age, she has likely completed most of her development. I would leave it for one year at most and see if the other breast has any growth. If not then just complete the reconstruction and let her get on with her life.
Tissue ingrowth could affect the fill valve
It certainly is safe to leave the port in as long as you want, but the longer the port is left, the greater the risk that tissue could grow along the tube to the valve and interfere with the valve, possibly causing deflation of the implant, and possibly preventing the valve from closing after the tube was removed.
Fill ports for adjustable breast implants
Adjustable implants with a fill port were used as an 'expander' implant by few surgeons for breast reconstruction, and even fewer for breast augmentation. The fill port can be left in place. Patients are self conscience of the port 'lump' and the softness and ripple of the implant make them less than suitable for long term use. We would suggest an implant that gives the best symmetry now, and consider the future need when it arrives. The standard saline implant can perform very well, and the gel implant is no panacea for breast asymmetry. We would suggest an additional consultation to make certain the whole plan is well thought out.
Best of luck,
Can I leave the port in my implant?
I frequently use adjustable implants both for breast reconstruction after cancer and for asymmetry. The implants that I use are designed to have the port left in, although patients often want them removed because they can feel them under the skin. They are easy to remove under local anaesthetic, but if they are not causing any problems, I am happy to leave them indefinitely.
The problem will be the difference in the breast shape
I would be concerned about the long term effect of the implant in one side to even out the size issue. The side with implant will be higher and will be firmer than the bigger side. The options for your daughter are limited because her breast are very different in shape and size. You can even out the size with implant,but the shape asymmetry can not be corrected with implant alone. I would suggest that you get multiple consultations before her surgery . I offer my patient fat grafting and lift to correct size and shape asymmetry.