The longer a patient has implants the greater the chances of developing complications, some of which will require more surgery. The “life” of these devices varies according to the individual. Some may need replacement surgery in just a few years, others may last 10-20 years and some even a lifetime. There are several different reasons why patients may need implant replacement surgery. Sometimes it is a matter of choice like size or implant style changes and sometimes removal and replacement is necessary because of a complication such as deflation, capsular contracture (hardening), pain or shifting of the implant.

MONITORING IS CRUCIAL ….

Breast implants make standard mammography difficult due to the displacement and atrophy of the native breast tissue. Thus it is important to inform your radiologist that you have implants. Special displacement views and additional views will be taken to improve the accuracy of the mammogram. Even in cases of bilateral skin sparing mastectomies, mammography is still necessary to evaluate and follow up any breast changes as well as implant characteristics over time.

A yearly ultrasound by a good radiologist will provide information regarding the integrity of the implant. I would recommend this investigation to be the determining factor as to when the implant should be replaced

During the first two weeks post surgery you should avoid soaking the wounds by avoiding bathing or showering. Overall avoid any strenuous exercise during the first four weeks and certainly while you

experience any pain or discomfort. The larger the implant you receive the heavier the breasts will be. You should wear good support bras while running to minimize pull on the skin and ptosis (drooping) of the breasts. I always recommend the use of two sports bras so as to minimize stretching of the breast skin.

Tanning salons and sun bathing will not harm the implant but may worsen the scarring. You should avoid getting sun or tanning rays on the incisions for at least one year after the surgery as the UV rays may darken the incisions permanently.

Smoking causes the blood vessels to constrict, reducing the blood supply and the oxygen carried by the blood to the surgical area. The tissues need blood and oxygen carried by blood to heal. When the blood supply is reduced the tissues heal more slowly and are prone to bacterial infection. This may ultimately lead to skin necrosis or death of patches of the skin and poor scarring compromising the aesthetic result.

There will be changes in nipple and breast sensation after surgery. The feeling may increase or decrease and be different in different areas. The sensory changes may be temporary or permanent.

Thus there may be a loss of feeling around the inner aspect of the breast. If the implant was placed partially under the muscle there will be a permanent weakness in upper body strength which will affect patients performance.

Breast feeding will not be affected unless the breasts were lifted at the same time.

Below follows a list of some of the more frequent complications associated with breast implants

Local compilcations i.e. around the breast

• Haematoma formation, collection of blood
• Seroma formation, collection of body fluid
• Delayed wound healing
• Wound sepsis
• Peri-implant infection
• Sensory changes in the breast

Systemic complications…. your body

• Fluid and electrolyte abnormalities
• Deep vein thrombosis, clotting in the legs
• Postoperative lung complications

• Rippling and contour deformities
• Malposition and displacement of the implant
• Asymmetries of the breast
• Capsular contracture (hardening of  the implant,  often painful caused by fibrous tissue around  the implant)
• Visibility of the implant around its edges Implant rupture, which can cause the silicone gel  to leak out into the neighbouring tissue or even  parts of the body
• Pain, from many causes including muscles spasms and nerve injury
• Pain from a foreign body in your body

MY RECOMMENDATIONS ARE AS

FOLLOWS: “IF WE WERE SUPPOSED TO HAVE SILICONE IN OUR BODIES WE WOULD HAVE BEEN BORN WITH IT. THUS YOU CANNOT EXPECT A FOREIGN BODY TO BEHAVE UNNOTICED IN YOUR BODY” IT WILL FEEL UNNATURAL BUT SOFT MOSTLY, IT MAY BECOME HARD, IT WILL REQUIRE REPLACEMENT AND YOUR BODY MAY NOT ACCEPT IT ALL.

Please visit your surgeon once a year for a clinical examination and perhaps also have a breast ultrasound once a year. Please be sure to keep the original identification of your implant as you may need it for insurance purposes later.

Thus your initial decision making as to why you choose to have silicone implants should be solid. Even if it is just want to fit into that sexy full bikini you need to understand the possible risks and benefits of silicone prosthesis.

Having said all of these, there are very few patients who regret choosing silicone prosthesis for reconstruction and even less so for augmentations.

Thank you for reading this article, we hope that we have answered some of the common questions associated with silicone implants.