Are Breast Implants Safe?
As far as we know – yes. They were taken off the market a few years ago in the USA due to concerns that they may cause connective tissue diseases such as SLE and rheumatoid arthritis, but large scale studies have shown no link between the implants causing these illnesses. However, breast enlargement is a surgical procedure and does carry with it potential risks and complications. It is important you have a frank conversation with your consultant and you are completely aware of the risks involved. If your surgeon tells you there are no risks then this is not true and you should look elsewhere for a surgeon. There is a possibility that you may need further surgery in the future. This could be due to your breasts changing shape or your implants may need to be replaced if they go hard (capsular contracture). You should be aware of all possible complications before you consent to breast enlargement surgery.
What do breast implants feel like?
This will depend on how much natural breast tissue you have because the first thing that you feel when you feel the breast will be your natural breast and certainly if you have any breast lumps you will be able to feel them just like you would if you did not have implants in. However, clearly your breast will be fuller with breast implants and your breast can feel firmer. This is more obvious in the first few months following breast enlargement surgery but then things soften and settle. Some implants do feel more firm than others, particularly the polyurethane foam implants which can feel more firm in the first year but then they settle and feel soft and natural. Occasionally you can feel the edge of the implant and this is particularly true in patients who are very slim without much covering over their chest and in patients who use bigger implants with a base width approaching the width of their breast.
Do implants look fake?
There is a public perception that patients with breast implants have large round fake looking breasts. The vast majority of patients who have breast enlargement just want to look normal, natural and have some volume restored back into their chest in keeping with their frame. It is important that the implants are sized and fitted to your chest and the current shape and volume of your breast is taken into account when choosing an implant. Whilst there is a group of patients who want to have a fake look, it is possible to have implants that do not look fake and a natural result is certainly very possible with the large range of shapes and sizes available.
Do they need to be changed every 10 years?
The most common reason for needing to change your breast implants after a breast enlargement, will be capsular contracture which is hardening of the implant due to scar tissue forming around it, this usually takes 5 or 10 years to happen. If this does happen then you may choose to have the implants changed although they do not necessarily have to be changed. They would only need to be changed if you are unhappy with the feel or the look of your implants due to the scarring around them. This is an important consideration and should be factored in with your decision making if you are considering breast implants because surgery to remove the scar tissue and replace the implants is more expensive than the initial breast enlargement surgery. When the implants are replaced it does create further scar tissue and so the implants that are put in do develop another capsule quicker the second time around. Polyurethane foam implants have a much lower rate of capsular contracture than silicone implants and so they are likely to last longer, although they can feel firmer in the first year but once they have softened they stay softer for longer.
Will the implants explode?
I have never heard of any implants exploding and I think this is a bit of a myth. Sometimes people worry about going into a pressurised situation such as diving. Aircraft flight is not a problem because the cabin pressure is normalised. Immediately following surgery there will be some air trapped in the pocket this would not be affected in a pressurised environment. I think when people talk about implants exploding they are referring to implant rupture which can occur but is rare with the premium implants that we use and will usually manifest as a change in shape or volume of the breast, particularly after significant trauma such as a road traffic accident.
What does FDA approval mean?
The FDA is the Food and Drug Administration, a body in America that approved devices such as breast implants. Many of the breast implants we use in the UK are not FDA approved and therefore could not be used in America. However, they all carry the CE mark which is the European equivalent. FDA approval is a very strict process and only necessary for the American market. I offer patients a full range of implants including those that are not FDA approved. However, if FDA approval is important to you I am very happy to use FDA approved implants. There are only two manufacturers of medical grade silicone gel in the world, they both make gel for FDA approved implants and so all silicone implants will contain gel from an FDA approved source.
What are Polyurethane Implants
Polyurethane implants are silicone implants with a polyurethane foam coating. This significantly reduces the risk of capsular contracture and has other benefits particularly in terms of implant positioning in that they do not tend to move and so rotation of teardrop implants is significantly reduced and the position of the implant is a lot more predictable. They do feel slightly firmer in the first year and occasionally you can feel the edges of the implant but these settle in time. There is some controversy surrounding polyurethane foam implants and so you will need to discuss the pros and cons with your surgeon. I believe they have a valuable role to play in breast implant surgery but need careful discussion so that you can make an informed decision as to whether they are right for you.
What about saline implants?
Saline implants are not really used in the UK. They are used more widely in America, particularly since silicone implants were banned for a period of time in America, so they had to use only saline implants. Silicone implants are no longer banned but saline implants are still used in the USA. We have never banned silicone implants and so have always used them here in the UK and I believe they give a superior result to saline implants. Saline implants have a silicone shell but the contents are saline and so if the shell ruptures there is no harm in the leakage or the contents. However, there is an increased risk of rippling with these implants and possibility of deflation over time and the cosmetic result can be compromised. If you would like to consider saline implants this is a discussion you can have with your surgeon to see if they would be suitable for you.
What about PIP implants?
The PIP scandal has highlighted the need to research your surgeon and the quality of the implants they are using. These were always low quality cheap implants and not many plastic surgeons ever use them. They were taken off the market long ago and the problems with them stemmed from the criminal activity of the manufacturer. This will always be difficult to ensure against. There are several major global brands for breast implants such as Nagor, Allergan, Mentor, Polytech and Silimed. The standards of the manufacturers are extremely high.
What if I get pregnant and I have breast implants?
Then there isn’t a problem. Breastfeeding is perfectly fine), the only problem is that your breasts may change in size and shape. This is perfectly natural as the breasts will fill with milk throughout pregnancy. A good plastic surgeon will recommend finishing your family before having breast enlargement for this very reason. However if you want breast implants before pregnancy it is perfectly safe.
Can you breast feed with implants?
If you are able to breastfeed now (some people are unable to) then the answer is yes. Implants are placed behind the breast and so all of the milk ducts are left in tact. A small amount of silicone may be found in the breast milk but is not harmful or significant. The same kind of silicone is found on the teats of baby formula bottles.
Can breast implants cause cancer?
No. There is no evidence to suggest that breast implants cause cancer and we frequently use breast implants in patients who have had cancer to reconstruct breast. The myth may have originated with a study conducted in the 1990’s where a high level of one of the chemicals used in the polyurethane implant (a popular type of implant originally developed in Brazil) was injected into cancer prone rats and the rats subsequently developed the disease.The chemical has never been shown to cause cancer in humans. After further studies, the FDA panel calculated the risk to be 1 in 1 million, the equivalent to smoking one cigarette in the lifetime of a patient in other words, the risk is negligible.