POSTOPERATIVE:

Pain and Discomfort:

This usually responds to appropriate medication. Most patients admit that the discomfort from this operation is not too severe.

Infection
Is uncommon and can be treated with antibiotics should it occur.

Scars
Most patients consider a short scar that is visible, a small price to pay for an otherwise pleasing result. On rare occasions scars may have to be revised if they become stretched or thickened but in most cases a barely perceptible thin line results.

Capsule Contracture
Immediately after the operation the process of healing begins. The body’s complex healing system recognizes that there is a foreign material (breast implant) present within it.

The net result is that a ‘protective’ layer of scar tissue is formed around the implant. This layer of scar tissue effectively seals off the ‘invading implant’ from the rest of the body. This protective layer of scar tissue is called a ‘capsule’. It is usually formed a few days after the operation and is thin and pliable. This is considered a normal occurrence and results in soft natural feeling breasts.

In the majority of cases capsules do not present a problem to the patient. In cases where there is pain or discomfort or where the breast becomes misshaped, further surgery will be necessary, usually in the form of removal of the capsule (capsulectomy) or cutting the capsular surgically to release the constricting effect (capsulotomy). It is important to realize that capsular contracture can recur after surgery in a proportion of patients.

Breast Investigations
Despite the presence of breast implants, it is still possible to perform mammography (breast x-rays). The radiologist should be informed so that the x-ray are taken from different directions. There are other methods of investigation including ultrasounds and nuclear magnetic resonance scanning for detecting and diagnosing lumps in the breast.


Beast Feeding
This is still possible after implantation. There is no evidence for an increase of illness in children who have been breast-fed by women with implants at the time of feeding.

Shape and Symmetry
It is extremely rare for two breasts to visibly symmetrical on close scrutiny. With implantation this asymmetry may be exaggerated further. Sometimes asymmetry may become more apparent after infection, capsular contraction or deflation of the implant. Where asymmetry is particularly apparent, different size implants may be inserted in an attempt to make the result more symmetrical. Perfect symmetry can never be promised nor guaranteed.

Sensory Changes
Some impairment of sensation in the nipple area may occur following surgery. Usually the sensation returns to normal in a few weeks and only rarely is partial sensory loss a permanent feature. Total permanent nipple sensory loss is extremely rare. Sometimes the nipple area can become extra sensitive temporarily.

Rejection
True rejection is extremely rare.

Rupture of the implant
With modern implants this is extremely rare. The actual incidence is unknown and research is ongoing. Rupture can result from deterioration of the implant shell with time, undetected damage at operation, a manufacturing flaw or as a result of severe trauma to the chest.

Implant lifespan
The message to be emphasized is that the breast implants are not guaranteed for life. There is ongoing debate regarding how long implants should be left in the body before being changed.


All patients should be investigated after a time to determine the integrity of there implants. Most surgeons would agree that a scan after 10 years (if not before) is a wise precaution. Most schools of thought would advocate a change of implant after 15 years. Research is ongoing.