I'm Thinking of Cancelling my Surgery. Research on Breast Augmentation is Giving Me Many Concerns.

I read one article that talked about how a large percentage of women have to have a revision within 5 years because of capsular contraction, rupturing, etc. I also read silicone could affect babies through breast feeding. One article linked breast implants to a cancer called anaplastic large-cell lymphoma. I'd have to be extremely selfish to have surgery out of vanity when there is so many complications, right? It seems like not enough is known about the surgery. Anything that can ease my mind?

Doctor Answers (16)

Concerned about risks of breast augmentation

+3

It is great that you have done research on breast augmentation. Unfortunately, not all the information may be correct or put the extent of the risks into perspective. That is what professionals such as reputable board certified plastic surgeons do: present to you the information and then you can decide whether or not your can accept those risks and all the relevant issues associated with those risks.

You should consider obtaining consultations from a few board certified plastic surgeons in your area. But be careful when you drive - you can potentially get into a fender bender or even worse. If your car is a compact, your risk is significantly elevated. And if you drive on the freeway, these injuries may even be fatal. And forget about appointments on Friday afternoon when people are racing to unwind - your risks...


Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 reviews

Cancelling Breast Augmentation Surgery

+2

The internet is a wonderful thing.  You can find out anything, true or false, about any topic.  And here in lies the problem.  Silicone implants have been on the market for over forty years.  In the early 1990's it was reported that breast implants caused various diseases.  This was an unsubstantiated report and opened the floodgates to litigation.  The implants went into a moratorium for the next 10 years.  During that time each patient that received the implants was studied both clinically and radiographically.  At the end of the study period the results were presented to the FDA.  The evidence indicated that there was no increase in diseases between women who received silicone breast implants and those that did not.  The moratorium was lifted.

The bottom line is that silicone in inert.  Meaning it does not react with anything and is totally safe. You will be able to find stories and "studies" that show otherwise.  But real, serious studies went into proving the safety of these devices.  They are safe.

As to the revision rate question.  The revision rate in the first 5 years is quite minimal.  Things like "bottoming out" or implant malposition can occur but are rare and can mostly be related to the initial surgical intervention.  The 25% revision rate that you've seen is quite skewed.  Over time patients may need a revision due to breast sagging, change in breast size etc.  In these circumstances the implants are usually changed because "while I'm in there...."

Breast implants are safe and the true revision rate is low.  My only recommendation is to have and inframammary fold incision used. I believe that the periareolar incision may lead to greater complications especially capsular contracture.

Christopher L. Hess, MD
Fairfax Plastic Surgeon
5.0 out of 5 stars 19 reviews

Breast augmentation, risks, and revision

+1

Although the re-operation rate and revision rate for breast augmentation is not high, it does exist.

I first want to point out that the risk of anaplastic large cell lymphoma is exceedingly rare and the possibility of a definite link is currently being investigated. A possible association in a small number of rare cases is being studied.

As for your other concerns, I think what you are getting at...is getting breast implants is not a one-time thing. It's a life decision. Breast implants are a medical device and do not last forever. Medical devices wear out over time.

Statistically speaking, you will at some point in your life, if you live long enough, live to see the day that you have to have one or both of your implants changed. Sometimes that is in the first five years but most often it is later.

Choosing to have breast implants is a personal decision that you will have to make for yourself.

Breast augmentation is a very common, popular and safe operation. Only you can decide if it is right for you.

 

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 39 reviews

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Breast Augmentation Risks

+1

Hello Emailmyhart,

Silicone and saline filled breast implants are associated with a fairly high risk of local problems that will lead to reoperation. Your risk based on a national average may be as high as 25% in first three years.  This is not your risk with any individual surgeon, and who you chose to do your breast augmenatation will have a significant effect on your risk for unforseen problems like capsular contracture, implant malposition, tissue stretch, rippling, etc.  This is why it is important to see doctors that are not only certified by the American Board of Plastic Surgery and who are also members of the American Society For Aesthetic Plastic Surgery, but are also highly reputed for breast surgery as well.  In the hands of an expert, your risk for local complications requiring another surgery may be as low as 1 to 2 %.

Neither silicone gel or saline filled breast implants cause any systemic illnesses, and are not harmful to nursing infants.

Anaplastic large cell lymphoma (ALCL) is a very rare disease, and 34 cases in the world have been identified where it has been associated with the breast implant capsule, the scar that normally surrounds the implant.  In all cases where a treatment has been recorded, the patient was 'cured' by removing the implants and the capsule, the ALCL behaving very much like a local disease, very different from ALCL found in other parts of the body.  The FDA and the American Society of Plastic Surgery have formed a joint task force to investigate this issue.  At this point, there is no apparent cause and effect relationship between ALCL and breast implants.

Go back to your surgeon and discuss these issues in detail, then make your decision.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 33 reviews

Concerns about risks for breast augmentation

+1

Breast augmentation is the number one most performed surgical procedure plastic surgeons provide - many, many women get this surgery done on a daily basis with great results and minimal problems.

Addressing your specific concerns, the overall rate of revision is low within a 5 year period. The highest revision rate of which I am aware is a 25% revision rate for women with saline implants over the first 10 years, and part of that group may be those who choose to change things, maybe volume, maybe saline to silicone. Silicone is not an issue for breast feeding either - the implants are placed under your breast, not within it. There are no documented studies of silicone passing from mother to baby, and in fact, silicone levels do not increase even in the mother - the implant is not reacting with the rest of the body, except to promote scar tissue around it, which is often satisfactory and soft. Anaplastic large cell lymphoma is a very rare occurrence after breast augmentation, and there is no absolute association confirmed yet. Anaplastic large cell lymphoma has most often been diagnosed from scar tissue around the implant, not as lymphoma that spreads through the body, so it is different than typical lymphoma. ALCL is about as likely to happen as getting hit by lightening. I would recommend you reconsider why you were interested in breast augmentation in the first place, and consider revisiting with your surgeon to discuss your concerns.

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 28 reviews

Concerns about Proceeding with Breast Augmentation

+1

Hi there-

I think it is important for you to put things into proper perspective...

While the realities of capsular contracture and the other unfavorable outcomes you describe cannot be denied, it remains true that overall, breast augmentation is associated with an astoundingly high rate of patient satisfaction.

If you're not ready, don't do it. But don't think for a minute that there is some deep dark secret out there that no one is telling you- all surgery has risks, and so does breast augmentation... but in healthy people under appropriate circumstances (Board Certified Plastic Surgeon, accredited facility, Board Certified Anesthesiologist, healthy patient) breast augmentation is among the safest procedures we perform.

Armando Soto, MD, FACS
Orlando Plastic Surgeon
5.0 out of 5 stars 110 reviews

Thinking of Canceling my Surgery. Research on Breast Aug Giving Me Many Concerns.Answer:

+1

Any surgery should be well thought out and you should feel nervous but committed about your decision. Breast Implants do require some “maintenance” over the years and they are not risk free. I would visit with your doctor again and tell him all of your concerns. But I am sure the other doctors on this panel would tell you what has been my experience. Of all the procedures I do, BA has the highest satisfaction and lowest complication rate!!

 

John J. Corey, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 19 reviews

Breast augmentation and risk

+1

Certainly as with all surgeries there are risks.  Unfortunately or fortunately, there is a lot of information "out there" that can confuse a person. If you are not 100% sure about having surgery, then don't do it.  If you are on the "fence," you shoudl probably speak to yoru doctor again.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

I'm Thinking of Cancelling my Surgery. Research on Breast Augmentation is Giving Me Many Concerns.

+1

If you are not 100% ready for ANY elective cosmetic surgery than I agree CANCEL. Best to have a detailed informed consent meeting with your surgeon before proceeding. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

Risks of breast augmentation

+1

To a certain degree, it is completely normal to have concerns and fears about an upcoming surgery.  Also, no surgical procedure is without risks.  Since you have concerns about the risks associated with breast augmentation, I would at the very lease discuss these concerns with your surgeon.  Your surgeon should be able to provide you with the risks and benefits of the procedure so that you can make a decision -- proceed with surgery or cancel surgery.

You mentioned several concerns in your question -- anaplastic large cell lymphoma (ALCL), breast feeding, and capsular contracture.  It may help to know that the risk of developing ALCL is less than that of getting struck by lightening and that there are fewer than 60 reported cases.  At this point, ASPS and the FDA are gathering more data about it because it is so rare and unusual.  The risk  of capsular contracture is about 6%; and you should still be able to breast feed without harm to your body.  

Keep in mind that a breast implant is a man-made object.  Nothing that is man-made is going to last forever -- your cell phone dies, your car needs to be replaced.  Think of breast implants in the same way.  Chances are that you will have another surgery sometime in your lifetime to replace them for some reason -- scarring, infection, changes in your body.

I hope that this helps.  As I said earlier, I would suggest that you discuss your concerns with your surgeon and decide if this surgery is right for you.  

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 10 reviews

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.