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Have you heard about Breast Prosthesis Disease?
In this article I explain what is myth and reality about Breast Implant Illness.
As physicians and plastic surgeons we have to ask the different industries that manufacture breast implants to ensure the care of the patients who wear their products, increasing the awareness of all parties in all matters concerning evidence-based medicine.
- Cancer: To date there is an ample amount of data that does NOT support the association between cancer and breast prostheses. In fact, many studies have seen a lower incidence (between 10-50%) of primary breast cancer in patients with breast implants.
- Connective tissue disease: Connective tissue diseases include: rheumatoid arthritis, polymyositis, dermatomyositis, scleroderma and Sjögren’s syndrome. Current evidence does not demonstrate an association between connective tissue disease and breast implant disease.
- Mental health: Coroneos (author of the study I quote at the bottom of this article) and his collaborators found no association between breast implants and the suicide rate in the United States. There is a Danish study that notes that women who underwent augmentation mammoplasty with implants had a higher prevalence of previous hospitalizations for psychiatric causes compared to patients who underwent reduction mammoplasty or other types of cosmetic surgery.
- Multiple sclerosis-type neurological disease: After 3 cohort studies* in large population groups, no association between breast implants and multiple sclerosis-type syndrome has been reported.
Few medical devices have undergone as much scrutiny as breast implants. At the present time, there is strong evidence to support that breast implants are safe.
The decision to have breast implants, keep them or remove them is a free choice for each patient.
If the patient desires an explant of her breast prostheses:
- You should consider removing the entire capsule, unless the posterior capsule is attached to the chest wall which could increase the risk of pneumothorax.
- In cases of anaplastic giant cell lymphoma, total capsulectomy is mandatory.
In the last 3 or 4 years there has been an increase in the number of consultations and surgeries for breast augmentation with the patient’s own fat(breast lipofilling).
It is a technique that I personally like very much to perform. Breast lipofilling or breast augmentation with own fat is indicated when the patient wants moderate breast augmentation because I put a maximum of 250-300 cc of own fat per breast and session. The consistency and shape of the breast is very natural and patients who have undergone this type of surgery have a very high rate of satisfaction.
Breast lipofilling or breast augmentation with fat is an alternative in some patients who have had breast implants removed and want to keep the volume of their breasts. In these cases, in addition to breast lipofilling or breast augmentation with fat, I perform a mastopexy or breast pexy to adjust the excess skin to the new volume of the breast.
*If you are interested in knowing what a ‘cohort study’ is, you can find more information on this Wikipedia page.
Sources used for this article:
- Silicone Implant Illness: Science versus Myth? (RJ Rohrich)
- US FDA Breast Implant Postapproval Studies: Long-term Outcomes in 99,993 Patients (CJ Coroneos)
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