Am I a candidate for a breast augmentation with having Ehlers Danlos syndrome?

Question

Recently, I had genetic testing done which showed a mutation in one of my collagen genes and as a result was diagnosed with Ehlers Danlos. Am I still eligible to have a breast augmentation or should I avoid all unnecessary surgeries?

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.Ehlers Danlos puts you at risks for poor healing.  Best to see a geneticist to determine the type of Ehlers Danlos you have and see if he/she will clear you for surgery.  From there you can discuss if you are a candidate for surgery with the plastic surgeon due to your diagnosis.The best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.best of luck!Dr Schwartz

Harry T. Haramis, MD, FACS · Answer

Unfortunately, that puts you at risk for poor healing.  With implants, it may result in malposition, bottoming out, exposure, etc. If your doctor clears you for the procedure, augmentation can still be performed but your chance of complications would be higher, provided you found a plastic surgeon comfortable to operate.

Robert M. Tornambe, MD · Answer

AbyThere are several factors affecting your decision to have elective breast augmentation surgery, including the severity of your ailment, existing symptoms, ages and anatomy. First, seek out genetic counseling to determine every aspect of your condition. If your doctor then thinks that breast surgery is an option, go to a board certified plastic surgeon and choose a more conservative route regarding size. Good Luck!

Nelson Castillo, MD · Answer

Thank you for your excellent question.  Patients with Ehlers Danlos tend to have skin and connective tissue that is friable and easily injured and demonstrates abnormal wound healing.  In my opinion, it would be best to avoid all unnecessary surgeries to minimize additional health risks to you.

Jeffrey A. Sweat, MD · Answer

There are many different forms and severities of Ehlers Danlos syndrome, but frequently people who are affected by this syndrome have scars that tend to widen or split open, which would put you at risk for implant exposure and then loss of the implant.  You should talk to you genetic counselor about your specific type of EDS to get a better idea about your risk for surgery, but really it would probably be better to avoid any unnecessary surgery.  Best of luck!

Michael J. Brown, MD · Answer

Hi,Thanks for posting your question. I am happy to try and help you. It is important to remember that a board certified plastic surgeon will be your best resource when it comes to an accurate assessment of your situation, and concerns. Having said that, there are varying degrees of expression of the syndrome. Small implants should be fine. I hope you found this helpful. Have a great day.

Thomas M. DeWire Sr., MD (retired) · Answer

Aby,Ehlers-Danlos syndrome has several variant types, and each can have varying degrees of expression.  The common feature of E-D syndrome is joint hyper extensibility (double-jointedness) hyperstretchable skin with preservation of elasticity (skin stretches more than usual, but mostly snaps back to normal dimension), tendency to stretchmark formation, and potential for wound-healing delay or scar stretch in some patients.  I prefer to use an axillary approach in my patients with Ehlers-Danlos syndrome. as that places the incisions remote to the position of the implants, and thus the implants place no tension on the healing incisions, even if there is a healing delay.  I have not actually seen wound healing problems in the patients I have with Ehlers Danlos, but I have seen undiagnosed Ehlers-Danlos lead to failure of a sternal repositioning for pectus excavatum  (Ravitch procedure) which had to be salvaged by subsequent placement of a Nuss bar for stability. There may be an added risk of implant bottoming-out with Ehlers-Danlos so any augmentation should be done by a technique that preserves the lower pectoralis muscle origins on the lower ribs, as those muscles provide lasting internal support for implants.  I would also recommend against use of large implants that stress internal support, as that may aggravate the tendency to loss of support, as well.   I hope that this helps.  Information regarding axillary augmentation approach with internal muscle support preservation is found at the link that follows.

Am I a candidate for a breast augmentation with having Ehlers Danlos syndrome?

Answers (7)

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