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Breast enlargement surgery: Side effects and potential risks

The Private Healthcare UK guide to cosmetic surgery contains articles on cosmetic and plastic surgery which are aimed at improving your knowledge of cosmetic surgery treatments, their benefits and potential risks. The guide is sponsored by Capio Cosmetic Surgery who have provided a personal, friendly and professional cosmetic surgery service for over a decade and have some of the highest qualified and experienced staff and plastic surgeons in the UK.
Breast enlargement surgery is usually carried out under general anaesthetic and therefore has the same risks as other invasive surgical procedures; any kind of surgical procedure carries a small risk of infection. The risk of infection is higher if a large haematoma (collection of blood) or seroma (collection of watery fluid) is present immediately after surgery.  The body is able to absorb small haematomas or seromas but may need the help of a surgical drain to remove larger ones.  Surgical draining can also increase the risk of deflation or rupturing.
 
It takes a few months for the breasts to settle after breast enlargement surgery and in the short term patients might experience some swelling, hardness and discomfort with some bruising, twinges and pains possibly over the first few weeks.  If patients suffer excessive swelling, deflated breasts, offensive wound discharge or excessive pain or heat in their breast they should report these symptoms immediately to their surgeon or GP. 
 

The most common risks of breast enlargement operations

The most common risk with breast implants is Capsular Contracture, though this is low with modern implants which have a textured silicone shell.  Capsular contracture is estimated to occur in around one in 10 women after breast implant surgery and requires further surgery to remove and replace the implant.  It occurs when the scar tissue that naturally forms around the breast implant begins to shrink causing the implant to harden and sometimes deform.
 
Rupturing occurs when the implant splits or tears but this does not necessarily create a medical problem as different fillers will react differently, and this was more common with early, thin-walled implants.  The obvious risk from ruptured implants is that the contents of the implant will escape from the shell into the breast and cause siliconomas (small lumps) which in turn cause tenderness or pain in the breast.  If this happens the implant needs to be taken out, but the firm silicon implants are less likely to cause these complications as they are designed to keep their shape even if the implant shell ruptures.  In the majority of cases the silicone gel will remain within the capsule that the body forms and can be removed if the ruptured implant is removed.
 
Deflation means that the implant has deflated and reduced in breast implant size. This can occur as a result of complications after surgery such as capsular contracture and rupturing.  Occasionally, implant surgery can cause small amounts of calcium to form around the implant, which may be confused as tumours on a mammography.
 
The silicone controversy.  The silicon implant has been the subject of much controversy after women claimed to have Connective Tissue Disorders (CTDs) and other illnesses from the silicone gel which related mainly to silicone gel leakage and possible migration to other parts of the body.  Reported symptoms included muscle spasm and pain, swollen and painful joints, rashes, changed eye and saliva fluid and hair loss.  However, studies show that the incidence of CTDs is no higher in women with silicon implants than with women without implants and the Independent Review Group's (IRG) report in 1998 found no scientific relationship between silicone gel implants and immune reactions, no relationship between silicone gel implants and long-term systemic illness (affecting the whole body), nor with specific connective tissue disease or non-specific systemic illness.
 
Breast Cancer.  Evidence suggests that women who have breast implants have no increased risk of developing breast cancer - in fact it is thought that the risk may actually be less.  However, if a woman who has breast implants develops breast cancer scientific studies have consistently shown that the risk of cancer recurring is no greater than in women without implants, and that there is no difference in their survival. 
 
In a small number of women scars will be red or highly coloured, thick, painful and will take several years to improve.  Other risks associated with breast implants include blood loss, creasing or rippling of the breast around the implant and a loss of sensation in the breast.  One in 10 women who have had breast implants experience fibrous capsules contracting which causes the implant to deform, become hard or painful.  In these cases then the implant and the capsule should be removed and if required replaced with another implant.
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